NPIMap

Individual provider Active NPI

Boyd K Southwick, DO

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1578613337
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O311 Issued in ID
Practice address
3614 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone
(208) 552-7700
Fax
(208) 552-1786
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O311 ID Primary

Addresses

Primary practice location

3614 Washington Pkwy
Idaho Falls, ID 83404-7573

Mailing address

3614 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone (208) 552-7700

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
I20100730000055 ID Practitioner - Family Practice 9537131065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family First Medical Center PLLCGroup PAC ID 1052480076, 18 clinicians

Practice addresses (Care Compare)

3820 Crestwood LN
Idaho Falls, ID 83404-4979
Phone 2085527700837

Hospital & facility affiliations

  • Mission Home Health of Idaho Falls Home health agency, Idaho Falls, ID, CCN 137120
  • Aspen Home Health Services Home health agency, Idaho Falls, ID, CCN 137081
  • Eden Home Health -Idahofalls Home health agency, Idaho Falls, ID, CCN 137119
  • Hands of Hope Hospice Hospice, Idaho Falls, ID, CCN 131547
  • Eden Hospice Hospice, Ammon, ID, CCN 131584
  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O311IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Medical Center, PLLC Family Medicine CurrentSince Jul 13, 2010 Accepting new patients
Family First Medical Center Past Accepting new patients
Hands of Hope Hospice, LLC Family Medicine PastSince Jan 1, 2019 Accepting new patients
Boyd K Southwick Family Medicine PastSince Aug 1, 2003 Accepting new patients

Locations

3820 Crestwood Ln
Idaho Falls, ID 83404
Phone (208) 552-7700

3614 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 535-4343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21377/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBAA
  • Direct secure messaging: boyd.southwick@ffmcif.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mission Hospice Services of Idaho FallsIdaho Falls, ID, CCN 131547 Hospice Contracted Managing Employee Jan 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 8

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1578613337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-552-7700",
            "fax_number": "208-552-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-552-7700",
            "fax_number": "208-552-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWICK",
        "first_name": "BOYD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.