Craig Richard Kai Pack, D.O.

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

O-1118 Issued in ID

Practice address

1955 Fremont Ave
Idaho Falls, ID 83402-1510

Phone

(208) 526-2195

Fax

(208) 526-8631

NPI assigned

Oct 17, 2005

Last updated

May 12, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1346239951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 FREMONT AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021510",
            "telephone_number": "208-526-2195",
            "fax_number": "208-526-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 FREMONT AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021510",
            "telephone_number": "208-526-2195",
            "fax_number": "208-526-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "CRAIG",
        "middle_name": "RICHARD KAI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "ID",
            "license": "O-1118",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Medicine Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Occupational Medicine Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.