NPIMap

Organization Active NPI

Pacific Rim Consulting LLC

  • Community/Behavioral Health Agency
  • Pocatello, ID
National Provider Identifier
1437585114
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC RIM CONSULTING LLC
Practice address
101 South Main Street
Pocatello, ID 83204-4321
Phone
(208) 232-8840
Fax
(208) 232-0925
NPI assigned
Sep 25, 2013
Last updated
Jul 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Authorized official

Name
Terry Fredrickson, CADC
Title
Owner, Counselor
Phone
(208) 232-8840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ID Primary

Addresses

Primary practice location

101 South Main Street
Pocatello, ID 83204-4321

Mailing address

101 South Main Street
Pocatello, ID 83204-4321
Phone (208) 232-8840

Other identifiers 1

IdentifierTypeStateIssuer
8067841MedicaidID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2343592Pacific Rim Consulting101 S Main St, Pocatello, ID 83204Certificate of waiverMay 7, 2028

National Provider Directory

National Provider Directory

Locations

101 S Main St
Pocatello, ID 83204
Phone (208) 221-1027

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1437585114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SOUTH MAIN STREET",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044321",
            "telephone_number": "208-232-8840",
            "fax_number": "208-232-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SOUTH MAIN STREET",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044321",
            "telephone_number": "208-232-8840",
            "fax_number": "208-232-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RIM CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "FREDRICKSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER, COUNSELOR",
        "authorized_official_telephone_number": "208-232-8840",
        "authorized_official_credential": "CADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8067841",
            "state": "ID"
        }
    ],
    "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 Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.