Justin Gregory Merzlock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71322 Issued in ID

Practice address

4511 Zebe Ave
Chubbuck, ID 83202-4707

Phone

(208) 904-4780

Fax

(208) 904-4832

NPI assigned

Jan 13, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Idaho Kidney Institute LLPGroup PAC ID 9032155312, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028
• Power County Hospital District Hospital, American Falls, ID, CCN 131304
• Caribou Medical Center Hospital, Soda Springs, ID, CCN 131309
• Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325
• Bear Lake Memorial Hospital Hospital, Montpelier, ID, CCN 131316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justinmerzlock@bmh.medalliesdirect.net
• FHIR API: https://fhir-usa.unify.chbase.com/org/powerco-3e8d4efb

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.

• Idaho Kidney Institute LLP

  • Nephrology Physician
  • Chubbuck, ID
  • NPI 1013064690
  Medicare reassignment Care Compare group NPD
• BMH, Inc.

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193
  Medicare reassignment NPD
• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  NPD
• BMH Inc.

  • Multi-Specialty Clinic/Center
  • Pocatello, ID
  • NPI 1548727571
  NPD
• BMH, Inc.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD
• BMH Inc.

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1770785875
  NPD (past)
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bear Lake County Memorial Hospital

  • Critical Access Hospital
  • Montpelier, ID
  • NPI 1336125533
  Care Compare affiliation
• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Care Compare affiliation
• Caribou Medical Center, Inc

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272
  Care Compare affiliation
• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation
• Power County Hospital District

  • Critical Access Hospital
  • American Falls, ID
  • NPI 1609874932
  Care Compare affiliation

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1013668847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14926 W BRANDY LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025345",
            "telephone_number": "208-251-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 ZEBE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024707",
            "telephone_number": "208-904-4780",
            "fax_number": "208-904-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERZLOCK",
        "first_name": "JUSTIN",
        "middle_name": "GREGORY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "71322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona L. Medicine Horse, LMSW
• Mark Vincent I Soriano Mendoza, DPT
• Mental Health Specialists
• Mental Health Specialists
• Daniella M Merzlock, LPC
• Karen J Michaelson, LCPC
• Cena May Miller
• Stevie Marie Miller
• Lauren Jane Mitchell
• Karlee Moeai

• Family Nurse Practitioner in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.