Organization Active NPI

South Central Public Health District

  • Public Health or Welfare Agency
  • Twin Falls, ID
National Provider Identifier
1285794339
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
SOUTH CENTRAL PUBLIC HEALTH DISTRICT
Practice address
1020 Washington St N
Twin Falls, ID 83301-3156
Phone
(208) 734-5900
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Mr. Rene Leblanc
Title
District Director
Phone
(208) 737-5902

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA-1046 ID

Addresses

Primary practice location

1020 Washington St N
Twin Falls, ID 83301-3156

Mailing address

1020 Washington St N
Twin Falls, ID 83301-3156
Phone (208) 734-5900

Other identifiers 6

IdentifierTypeStateIssuer
002848800MedicaidID
805344600MedicaidID
805321100MedicaidID
806204600MedicaidID
0556324MedicaidID
002891000MedicaidID

Other names 1

  • PUBLIC HEALTH DISTRICT V Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000272 ID Part B Supplier - Mass Immunization (Roster Biller Only) 0042393852 Practice locations: Bellevue, ID; Gooding, ID; Heyburn, ID; Jerome, ID; Twin Falls, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D0687831South Central Public Health District1020 Washington St N, Twin Falls, ID 83301Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Locations

2311 Park Ave
Ste 4
Burley, ID 83318
Phone (208) 678-8221

255 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4477

485 Roger Ave
Heyburn, ID 83336
Phone (208) 678-8221

951 E Avenue H
Jerome, ID 83338
Phone (208) 324-8838

1218 9th St
Ste 15
Rupert, ID 83350

104 W B St
Shoshone, ID 83352
Phone (208) 934-4477

1020 Washington St N
Twin Falls, ID 83301
Phone (208) 734-5900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1285794339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WASHINGTON ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013156",
            "telephone_number": "208-734-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WASHINGTON ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013156",
            "telephone_number": "208-734-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL PUBLIC HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "DISTRICT DIRECTOR",
        "authorized_official_telephone_number": "208-737-5902",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002848800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805344600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805321100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806204600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0556324",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002891000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PUBLIC HEALTH DISTRICT V",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.