Active NPI
John F Trotter, M.D.
- Pediatrics Physician
- Twin Falls, ID
National Provider Identifier
1649213729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- M4251
- Practice address
- 775 Pole Line Rd W
Suite 111
Twin Falls, ID 83301-5814 - Phone
- (208) 814-8000
- Fax
- (208) 733-9402
- NPI assigned
- Jun 14, 2006
- Last updated
- Jan 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M4251 | ID | Primary |
Addresses
Primary practice location
775 Pole Line Rd W
Suite 111
Twin Falls, ID 83301-5814
Mailing address
PO Box 587
Twin Falls, ID 83303-0587
Phone (208) 814-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003981200 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M4251 | ID | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magic Valley Regional Medical Center | Past | Accepting new patients | |
| St Luke's Magic Valley Regional Medical Center LTD | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420675200000",
"number": "1649213729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 587",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833030587",
"telephone_number": "208-814-7400",
"fax_number": "208-814-7491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 POLE LINE RD W",
"address_2": "SUITE 111",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015814",
"telephone_number": "208-814-8000",
"fax_number": "208-733-9402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROTTER",
"first_name": "JOHN",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2015-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ID",
"license": "M4251",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003981200",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.