Blackfoot Medical Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLACKFOOT MEDICAL CLINIC, INC

Practice address

114 S Main St
Firth, ID 83236

Phone

(208) 346-6614

NPI assigned

Sep 22, 2006

Last updated

Jun 5, 2008By 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

Sheila Tibbitts

Title

Administrator

Phone

(208) 785-2600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1275633208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST",
            "city": "FIRTH",
            "state": "ID",
            "postal_code": "83236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST",
            "city": "FIRTH",
            "state": "ID",
            "postal_code": "83236",
            "telephone_number": "208-346-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKFOOT MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "TIBBITTS",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-785-2600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806884200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheyann Marie Bair
• Jacob David Barney, FNP-C
• Kathleen Ann Baron, APRN, CNP, FNP, PNP
• Alaina Maren Christensen
• Firth Medical Center PLLC
• Firth School District
• Karla Kae Hess, FNP-C
• Kathleen L Searle, FNP

• Family Medicine Physician in Firth, ID
• Providers in Firth, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.