Individual provider Active NPI

Dave Robinson, PA-C

  • Physician Assistant
  • Rexburg, ID
National Provider Identifier
1003257478
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1376 Issued in ID
Practice address
72 S 1St E Ste 101
Rexburg, ID 83440-1902
Phone
(208) 356-4900
Fax
(208) 356-3724
NPI assigned
Jul 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1376 ID Primary

Addresses

Primary practice location

72 S 1St E Ste 101
Rexburg, ID 83440-1902

Mailing address

PO Box 18
Saint Anthony, ID 83445-0018
Phone (208) 356-4900

Other practice location 1

335 E Main St Ste 1
Saint Anthony, ID 83445-1546
Phone (208) 356-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2288OKMDCorneal and Contact Management Optometrist
PA-1376IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Sports and Orthopedics Institute PLLC Past Accepting new patients
Just 4 Kids Health LLC Past Accepting new patients
Eagle Community Clinic LLC Past Accepting new patients
Just 4 Kids Health LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1003257478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834450018",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S 1ST E STE 101",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401902",
            "telephone_number": "208-356-4900",
            "fax_number": "208-356-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 E Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Saint Anthony",
            "state": "ID",
            "postal_code": "834451546",
            "country_code": "US",
            "telephone_number": "208-356-4900",
            "fax_number": "208-356-4116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "DAVE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.