Organization Active NPI

BMH, Inc.

Doing business as Cedar Creek Family Medicine

  • Family Medicine Physician
  • Blackfoot, ID
National Provider Identifier
1326245010
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BMH, INC.
Doing business as
Cedar Creek Family Medicine
Practice address
98 Poplar St
Blackfoot, ID 83221-1758
Phone
(208) 782-3700
NPI assigned
Jun 27, 2007
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Jacob Erickson
Title
Ceo
Phone
(208) 785-3801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

98 Poplar St
Blackfoot, ID 83221-1758

Mailing address

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 782-3700

Other identifiers 3

IdentifierTypeStateIssuer
8N216OtherIDBLUE CROSS GRP
8L618OtherIDBLUE CROSS GRP OLD
002854200MedicaidID

Other names 1

  • Cedar Creek Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071018000897 ID Part B Supplier - Clinic/Group Practice 8426149758 Receives reassigned benefits from 183 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blackfoot, ID; Ammon, ID; Pocatello, ID; Idaho Falls, ID

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1326245010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-785-3801"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GRP",
            "identifier": "8N216",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GRP OLD",
            "identifier": "8L618",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002854200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Creek Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedar Creek Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.