NPIMap

Organization Active NPI

Sterling Physician Group PLLC

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
National Provider Identifier
1487994430
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
STERLING PHYSICIAN GROUP PLLC
Practice address
740 S. Woodruff Ave
Idaho Falls, ID 83401
Phone
(208) 542-9111
Fax
(208) 542-9114
NPI assigned
Feb 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Corbin Bunnage, PANPI 1447325485
Title
Manager
Phone
(208) 542-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

740 S. Woodruff Ave
Idaho Falls, ID 83401

Mailing address

740 S. Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

Other practice location 1

1201 S Main St Ste 110
Logan, UT 84321-8504
Phone (435) 787-8504

Other practice location 2

1404 Pomerelle Ave Ste A1
Burley, ID 83318-2013
Phone (208) 878-8783

Other practice location 3

630 E 1400 N Ste 150
North Logan, UT 84341-2549
Phone (435) 514-4465

National Provider Directory

National Provider Directory

Locations

1404 Pomerelle Ave
Ste 1
Burley, ID 83318
Phone (208) 878-8783

Practitioners & affiliated clinicians

Practitioners 2

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": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1487994430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S. WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S. WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "843218504",
            "country_code": "US",
            "telephone_number": "435-787-8504",
            "fax_number": "435-787-8509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1404 Pomerelle Ave Ste A1",
            "address_purpose": "LOCATION",
            "city": "Burley",
            "state": "ID",
            "postal_code": "833182013",
            "country_code": "US",
            "telephone_number": "208-878-8783",
            "fax_number": "208-878-8786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 E 1400 N Ste 150",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843412549",
            "country_code": "US",
            "telephone_number": "435-514-4465",
            "fax_number": "435-799-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STERLING PHYSICIAN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BUNNAGE",
        "authorized_official_first_name": "CORBIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-542-9111",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.