Gabrielle Abernathy

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-2619 Issued in ID

Practice address

500 S 11TH Ave Ste 100
Pocatello, ID 83201-4877

Phone

(208) 232-6214

NPI assigned

Jun 13, 2022

Sex

Female

Sole proprietor

No

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.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2025.

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1104556182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 100",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014877",
            "telephone_number": "208-232-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 100",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014877",
            "telephone_number": "208-232-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-2619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A to Z Family Services Inc.
• A to Z Family Services, Inc.
• A to Z Family Services, Inc.
• A2C Corporation
• Aaron J Altenburg MD PC
• Abiding Self Inc
• Lee Ann Roberts Abraszewski, NP
• Nina Kellie Lateefee Abul-Husn, MD, MSPH
• Accessible Wellness
• Ontaya Acedo, LMSW

• All providers in Pocatello, ID
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; 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.

Verify at the official NPI Registry.