NPIMap

Organization Active NPI

Machen Family Medicine, PC

Doing business as Shane G Machen, DO

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1013204445
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-0611 Issued in ID
Legal business name
MACHEN FAMILY MEDICINE, PC
Doing business as
Shane G Machen, DO
Practice address
1995 E 17TH St Ste a
Idaho Falls, ID 83404-6493
Phone
(208) 522-7666
Fax
(208) 524-2821
NPI assigned
Jul 6, 2011
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MACHEN FAMILY MEDICINE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Shane G Machen, DONPI 1932330370
Title
Owner
Phone
(208) 522-7666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X O-0611 ID Primary

Addresses

Primary practice location

1995 E 17TH St Ste a
Idaho Falls, ID 83404-6493

Mailing address

1995 E 17TH St Ste a
Idaho Falls, ID 83404-6493
Phone (208) 522-7666

Other names 1

  • SHANE G MACHEN, DO Doing business as

National Provider Directory

National Provider Directory
Part of
Machen Family Medicine PC

Locations

1995 E 17th St
Ste A
Idaho Falls, ID 83404
Phone (208) 522-7666

3500 Potomac Way
Idaho Falls, ID 83404
Phone (208) 522-7666

3500 Potomac Way
Ste A
Idaho Falls, ID 83404

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAGBCA

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1013204445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046493",
            "telephone_number": "208-522-7666",
            "fax_number": "208-524-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046493",
            "telephone_number": "208-522-7666",
            "fax_number": "208-524-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACHEN FAMILY MEDICINE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MACHEN FAMILY MEDICINE, PC",
        "enumeration_date": "2011-07-06",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "MACHEN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-522-7666",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHANE G MACHEN, DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.