NPIMap

Individual provider Active NPI

Sam Jensen Wright, PA

  • Medical Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1457023244
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-2117 Issued in ID
Practice address
2725 Channing Way
Idaho Falls, ID 83404-7510
Phone
(208) 525-8448
NPI assigned
Sep 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-2117 ID Primary

Addresses

Primary practice location

2725 Channing Way
Idaho Falls, ID 83404-7510

Mailing address

2725 Channing Way
Idaho Falls, ID 83404-7510

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
I20211025002019 ID Practitioner - Physician Assistant 4486042405 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Imaging Associates of Idaho Falls IncGroup PAC ID 7618876590, 66 clinicians

Practice addresses (Care Compare)

2001 S Woodruff Ave
Suite 17
Idaho Falls, ID 83404-6372
Phone (208) 524-7237

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 715-5220

2327 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 715-5220

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 715-5220

450 E Main St
Reburg, ID 83440-2048
Phone (208) 715-5220

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 715-5220

Hospital & facility affiliations

  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325
  • Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging Associates of Idaho Falls, Inc CurrentSince Apr 5, 2024 Accepting new patients
Mountain View Hospital LLC CurrentSince Sep 20, 2021 Accepting new patients
Community Care Pocatello PLLC Current Accepting new patients
Community Care Current Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2001 S Woodruff Ave
Ste 17
Idaho Falls, ID 83404
Phone (208) 524-7237

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

444 Hospital Way
Ste 111
Pocatello, ID 83201

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

425 E 4th N
Rexburg, ID 83440

Organizations & group practices 11

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

Hospital & facility affiliations 6

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": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1457023244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047510",
            "telephone_number": "208-525-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "SAM",
        "middle_name": "JENSEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-2117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.