NPIMap

Organization Active NPI

Idaho State University Health Center

  • Student Health Clinic/Center
  • Pocatello, ID
National Provider Identifier
1336214618
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
IDAHO STATE UNIVERSITY HEALTH CENTER
Practice address
990 Cesar Chavez Ave
Pocatello, ID 83209-0001
Phone
(208) 282-2330
Fax
(208) 282-4036
NPI assigned
Nov 21, 2006
Organization subpart
Yes
Parent organization
IDAHO STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Authorized official

Name
Dr. Ronald M Solbrig, MD
Title
Director
Phone
(208) 282-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

990 Cesar Chavez Ave
Pocatello, ID 83209-0001

Mailing address

921 S 8TH Ave Stop 8311
Pocatello, ID 83209-0002
Phone (208) 282-2330

National Provider Directory

National Provider Directory
Tax ID family
Idaho State University22 organizations share this tax ID, including this one
Part of
Idaho State University

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

990 Cesar Chavez
Pocatello, ID 83209
Phone (208) 282-2330

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1336214618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8311",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "208-282-2330",
            "fax_number": "208-282-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 CESAR CHAVEZ AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090001",
            "telephone_number": "208-282-2330",
            "fax_number": "208-282-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO STATE UNIVERSITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDAHO STATE UNIVERSITY",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "SOLBRIG",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-282-2330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.