RSM PA PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA220 Issued in ID

Legal business name

RSM PA PLLC

Doing business as

Family First Health Centers South

Practice address

1595 Bannock Hwy
Pocatello, ID 83204

Phone

(208) 238-0400

Fax

(208) 238-0401

NPI assigned

Oct 9, 2007

Last updated

Oct 9, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roger Scott Malm, PA

Title

Owner

Phone

(208) 238-0400

Specialties & licenses 1

Addresses

Other names 1

• Family First Health Centers South Doing business as

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1174711758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 BANNOCK HWY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83204",
            "telephone_number": "208-238-0400",
            "fax_number": "208-238-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 BANNOCK HWY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83204",
            "telephone_number": "208-238-0400",
            "fax_number": "208-238-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSM PA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "MALM",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-238-0400",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family First Health Centers South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roth Family Medicine and Mental Health
• Kathryn Jill Roth, FNP-C
• Kyle A Roth, NP
• Elizabeth Lassen Rowden, MS, RDN, LD
• Nathan T. Rowe, NP-C
• Tenille Rudeen, SLP
• Rufus O. Van Dyke, D.D.S., M.CL.D
• Jennifer Ruiz
• Richard Willis Runyan, M.D.
• Nadilyn Michelle Rushton, OTL-2777

• Medical Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.