NPIMap

Organization Active NPI

Heroic Diabetes Incorporated

  • Pediatrics Physician
  • Meridian, ID
National Provider Identifier
1508742909
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HEROIC DIABETES INCORPORATED
Practice address
4214 N Ambercreek Ave
Meridian, ID 83646-7019
Phone
(208) 821-4136
NPI assigned
Aug 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Jaren Smith, RN, BSNNPI 1912835281
Title
President
Phone
(208) 821-4136

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4214 N Ambercreek Ave
Meridian, ID 83646-7019

Mailing address

1302 Meadowview Ave
Rexburg, ID 83440-5079

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1508742909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 MEADOWVIEW AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 N AMBERCREEK AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467019",
            "telephone_number": "208-821-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEROIC DIABETES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-821-4136",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.