Adam Packer, NP
Individual provider Active NPI Family Nurse Practitioner · Pocatello, ID
NPI 1669858734 · NPPES record last updated Aug 24, 2015
Key facts
- NPI
- 1669858734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NP-1611A (ID)
- Practice address
- 777 Hospital Way
Pocatello, ID 83201-5175 - Phone
- (208) 239-1029
- Fax
- (208) 239-3754
- NPI assigned
- Jul 30, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MVH Pic LLC
Practice addresses (Care Compare)
495 Yellowstone Ave
Pocatello, ID 83201-4531
Phone (208) 478-7422
Hospital & facility affiliations
- Mountain View Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150914002010 | ID | Practitioner - Nurse Practitioner | 4385951037 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pocatello Health Services, LLC | Current |
Accepting new patients | |
| Pocatello Hospital LLC | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current |
Accepting new patients | |
| Mountain View Hospital LLC | Past |
Accepting new patients |
Locations
777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000
777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP-1611A | ID | Yes |
Addresses
Primary practice location
777 Hospital Way
Pocatello, ID 83201-5175
Mailing address
PO Box 4168
Pocatello, ID 83205-4168
Phone (208) 239-2065
Other providers in Pocatello, ID
- Ayeli V Ovalles Soto
- Christopher Taft Owens
- Amy Pabawena
- Brandon Pace
- Pacific Rim Consulting LLC
- Pain Relief Institute
- Melissa Palmer
- Timothy Garr Palmer
- Emily Pannier
- Noe Adan Paramo
All providers in Pocatello, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.