NPIMap

Individual provider Active NPI

Lauren Clelland, MD

  • Family Medicine Physician
  • Buhl, ID
National Provider Identifier
1336761063
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-16109 Issued in ID
Practice address
980 Burley Ave
Buhl, ID 83316-1849
Phone
(208) 814-8000
NPI assigned
May 15, 2020
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-16109 ID Primary

Addresses

Primary practice location

980 Burley Ave
Buhl, ID 83316-1849

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

132 5th Ave W Ste 2
Jerome, ID 83338-1825
Phone (208) 814-9800

Other names 1

  • Lauren Nesbit Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810003375 ID Practitioner - Family Practice 8325461841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5819

980 Burley Ave
Buhl, ID 83316-1849
Phone (208) 814-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC Family Medicine CurrentSince Jul 20, 2023 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD PastSince Aug 6, 2023 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

980 Burley Ave
Buhl, ID 83316
Phone (208) 814-9150

132 5th Ave W
Ste 2
Jerome, ID 83338
Phone (208) 324-5286

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1336761063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BURLEY AVE",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833161849",
            "telephone_number": "208-814-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 5th Ave W Ste 2",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833381825",
            "country_code": "US",
            "telephone_number": "208-814-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLELLAND",
        "first_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-16109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "NESBIT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buhl, ID

Sources for this page

Verify at the official NPI Registry.