Individual provider Active NPI

Preston Boyd Christensen, MD

  • Family Medicine Physician
  • Soda Springs, ID
National Provider Identifier
1376120253
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-17793 Issued in ID
Practice address
300 South 3Rd East
Soda Springs, ID 83276
Phone
(208) 547-2916
Fax
(801) 387-5333
NPI assigned
Mar 26, 2021
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X M-17793 ID Primary

Addresses

Primary practice location

300 South 3Rd East
Soda Springs, ID 83276

Mailing address

300 South 3Rd East
Soda Springs, ID 83276
Phone (208) 547-2916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230316002763 UT Practitioner - Family Practice 8820462682 Reassigns benefits to 1 organization
I20250325002920 ID Practitioner - Family Practice 8820462682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caribou Memorial HospitalGroup PAC ID 6103734777, 15 clinicians
Caribou Medical Center, IncGroup PAC ID 7618365701, 35 clinicians

Practice addresses (Care Compare)

300 S 3Rd
Soda Springs, ID 83276-1559

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-17793IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 1, 2023 Accepting new patients
Caribou Medical Center, Inc CurrentSince Jan 18, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Caribou Medical Center, Inc CurrentSince Jan 18, 2025 Accepting new patients

Locations

300 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-0700

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

4403 Harrison Blvd
Ste 700A
Ogden, UT 84403

Organizations & group practices 5

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 3

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1376120253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTH 3RD EAST",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "83276",
            "telephone_number": "208-547-2916",
            "fax_number": "208-547-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SOUTH 3RD EAST",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "83276",
            "telephone_number": "208-547-2916",
            "fax_number": "801-387-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "PRESTON",
        "middle_name": "BOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-06-05",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-17793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soda Springs, ID

Sources for this page

Verify at the official NPI Registry.