Active NPI
Patrick Connor Spotts, MD
- Emergency Medicine Physician
- Idaho Falls, ID
National Provider Identifier
1053832212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 41056
- Practice address
- 2325 Coronado St
Idaho Falls, ID 83404-7407 - Phone
- (864) 416-1090
- NPI assigned
- Jun 28, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 41056 | SC | Primary |
| Emergency Medicine Physician | 207P00000X | M-14679 | ID |
Addresses
Primary practice location
2325 Coronado St
Idaho Falls, ID 83404-7407
Mailing address
2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (864) 416-1090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-14679 | ID | MD | Emergency Medicine Physician |
| 41056 | SC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain View Hospital LLC | Current | Accepting new patients | |
| McLeod Health Cheraw | Current | Accepting new patients | |
| Steele Memorial Medical Center | Current | Accepting new patients | |
| Steele Memorial Medical Center | Current | Accepting new patients | |
| McLeod Health Cheraw | Emergency Medicine | Current | Accepting new patients |
Locations
2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686
203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291
711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304
Interoperability endpoints
- pspotts2204158@wm.providencedirect.org
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
-
- Critical Access Hospital
- Salmon, ID
- NPI 1851403265
-
- Certified Registered Nurse Anesthetist
- Cheraw, SC
- NPI 1275912974
Emergency Medicine
-
- Medicare Defined Swing Bed Hospital Unit
- Salmon, ID
- NPI 1992913479
-
- Rural Health Clinic/Center
- Darlington, SC
- NPI 1003410903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769817600000",
"number": "1053832212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 CORONADO ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047407",
"telephone_number": "864-416-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2325 CORONADO ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047407",
"telephone_number": "864-416-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOTTS",
"first_name": "PATRICK",
"middle_name": "CONNOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-28",
"last_updated": "2026-01-31",
"certification_date": "2026-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "41056",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ID",
"license": "M-14679",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 31, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.