Mark Mitchell Roubidoux II, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

39235 Issued in ID

Practice address

336 Warner Dr Ste 4a
Lewiston, ID 83501-4441

Phone

(208) 305-3537

Fax

(877) 376-4040

NPI assigned

Sep 28, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unlimited Health ChiropracticGroup PAC ID 7315071339, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mitchr@nimiipuuhealth.directbygreenway.com

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.

• Unlimited Health Chiropractic

  • Chiropractor
  • Coeur D Alene, ID
  • NPI 1639402530

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522

  Single Specialty

  Medicare reassignment NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Lewiston, ID
  • NPI 1588413694

  Single Specialty

  NPD

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1629685235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NEIDER AVE STE 103",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838156007",
            "telephone_number": "208-930-4944",
            "fax_number": "877-376-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 WARNER DR STE 4A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-305-3537",
            "fax_number": "877-376-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUBIDOUX",
        "first_name": "MARK",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "39235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosauers Supermarkets Inc
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• Amanda Roth
• Angela Ruth Roth, M.D.
• Brian Rothfusz, R.PH.
• William Westel Rowe, MD
• Shannon R. Rowland, PMHNP
• Margeret Roy
• Monali Roy
• Royal Plaza Retirement Center Lewiston, LLC

• Nurse Practitioner in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.