NPIMap

Organization Active NPI

Rocky Mountain Medical LLC

  • Internal Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1295580082
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROCKY MOUNTAIN MEDICAL LLC
Practice address
535 W Sunnyside Rd Ste 2
Idaho Falls, ID 83402-4647
Phone
(208) 357-9700
Fax
(208) 963-3245
NPI assigned
Apr 23, 2024
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Matthew Wood
Title
Director
Phone
(208) 357-9700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

535 W Sunnyside Rd Ste 2
Idaho Falls, ID 83402-4647

Mailing address

535 W Sunnyside Rd Ste 2
Idaho Falls, ID 83402-4647
Phone (208) 357-9700

Other practice location 1

23 S 8th St
Ashton, ID 83420-5211
Phone (208) 330-3007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802001219 ID Part B Supplier - Clinic/Group Practice 1759828122 Receives reassigned benefits from 4 practitioners
Practice locations: Ashton, ID; Idaho Falls, ID

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1295580082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W SUNNYSIDE RD STE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024647",
            "telephone_number": "208-357-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W SUNNYSIDE RD STE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024647",
            "telephone_number": "208-357-9700",
            "fax_number": "208-963-3245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Ashton",
            "state": "ID",
            "postal_code": "834205211",
            "country_code": "US",
            "telephone_number": "208-330-3007",
            "fax_number": "800-861-3329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-357-9700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "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 Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.