Idaho Urgent Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IDAHO URGENT CARE

Practice address

740 S Woodruff Ave
Idaho Falls, ID 83401-5285

Phone

(208) 542-9111

Fax

(208) 542-9114

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Candace Marie Bunnage

Title

Billing Manager

Phone

(208) 542-9111

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649345661",
    "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": "834015285",
            "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": "834015285",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNNAGE",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-542-9111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "8F280",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Physician Services Inc.
• Idaho Prosthetics & Orthotics, Inc.
• Idaho Psychiatric Institute
• Idaho Recovery Center, LLC.
• Idaho Surgicenter North LLC
• Idaho Vacation Rentals LLC
• Ideal Solutions, Inc.
• If Hospice Opco LLC
• Ifcc PLLC
• Ihc Health Services Inc

• Family Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.