NPIMap

Organization Active NPI

Blackfoot Medical Clinic Surgeons

  • Surgery Physician
  • Blackfoot, ID
National Provider Identifier
1740580794
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BLACKFOOT MEDICAL CLINIC SURGEONS
Practice address
1441 Parkway Dr
Blackfoot, ID 83221-1667
Phone
(208) 785-2600
NPI assigned
Oct 25, 2010
Last updated
Oct 25, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
BLACKFOOT MEDICAL CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
Kerry Casperson
Title
Administrator
Phone
(208) 785-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1441 Parkway Dr
Blackfoot, ID 83221-1667

Mailing address

1441 Parkway Dr
Blackfoot, ID 83221-1667
Phone (208) 785-2600

National Provider Directory

National Provider Directory
Tax ID family
Cigna Finance3 organizations share this tax ID, including this one
Part of
Cigna Finance

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1740580794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 PARKWAY DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211667",
            "telephone_number": "208-785-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 PARKWAY DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211667",
            "telephone_number": "208-785-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKFOOT MEDICAL CLINIC SURGEONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLACKFOOT MEDICAL CLINIC INC",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "CASPERSON",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-785-2600"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.