NPIMap

Organization Active NPI

Idaho State University Department of Family Medicine

  • Community/Behavioral Health Agency
  • Pocatello, ID
National Provider Identifier
1780032326
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE
Practice address
465 Memorial Dr
Pocatello, ID 83201-4008
Phone
(208) 282-4141
NPI assigned
May 24, 2016
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH WEST INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Laurie Powell
Title
Authorization Specialist
Phone
(208) 232-6260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

465 Memorial Dr
Pocatello, ID 83201-4008

Mailing address

1000 N 8TH Ave
Pocatello, ID 83201-5757
Phone (208) 232-6260

National Provider Directory

National Provider Directory
Tax ID family
Lakeview Medical Clinic46 organizations share this tax ID, including this one
Part of
Lakeview Medical Clinic

Other organizations with this tax ID 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1780032326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N 8TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015757",
            "telephone_number": "208-232-6260",
            "fax_number": "208-232-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-282-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH WEST INC.",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "AUTHORIZATION SPECIALIST",
        "authorized_official_telephone_number": "208-232-6260"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.