NPIMap

Organization Active NPI

Fremont Medical Services PC

  • Clinic/Center
  • Island Park, ID
National Provider Identifier
1407026560
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
M4566 Issued in ID
Legal business name
FREMONT MEDICAL SERVICES PC
Practice address
3765 Highway 20 S
Island Park, ID 83429
Phone
(208) 558-7766
NPI assigned
Mar 5, 2008
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
FREMONT MEDICAL SERVICES PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Dr. Stephen Cheyne, MD
Title
President
Phone
(208) 558-7766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X M4566 ID Primary

Addresses

Primary practice location

3765 Highway 20 S
Island Park, ID 83429

Mailing address

PO Box 826
Ashton, ID 83420-0826

Other names 1

  • Island Park Medical Clinic Other name

National Provider Directory

National Provider Directory
Part of
Fremont Medical Services PC

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1407026560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 826",
            "city": "ASHTON",
            "state": "ID",
            "postal_code": "834200826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3765 HIGHWAY 20 S",
            "city": "ISLAND PARK",
            "state": "ID",
            "postal_code": "83429",
            "telephone_number": "208-558-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT MEDICAL SERVICES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREMONT MEDICAL SERVICES PC",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "CHEYNE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-558-7766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "M4566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Park Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Island Park, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.