NPIMap

Organization Active NPI

BMH, Inc.

  • Dermatology Physician
  • Idaho Falls, ID
National Provider Identifier
1780123950
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BMH, INC.
Practice address
3760 Washington Pkwy
Idaho Falls, ID 83404-7593
Phone
(208) 535-3637
Fax
(208) 522-2705
NPI assigned
Feb 21, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jacob Erickson
Title
Ceo
Phone
(208) 785-3801

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071018000897 ID Part B Supplier - Clinic/Group Practice 8426149758 Receives reassigned benefits from 183 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blackfoot, ID; Ammon, ID; Pocatello, ID; Idaho Falls, ID

National Provider Directory

National Provider Directory
Tax ID family
BMH Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

3760 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 524-4953

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X ID Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X ID
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X ID

Addresses

NPPES NPI Registry

Primary practice location

3760 Washington Pkwy
Idaho Falls, ID 83404-7593

Mailing address

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 782-3969

Other names 2

NPPES NPI Registry
  • BINGHAM HEALTHCARE SPECIALTY CLINIC - WASHINGTON Doing business as
  • BINGHAM MEMORIAL SPECIALTY CLINIC - WASHINGTON Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 18, 2019.

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1780123950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3969",
            "fax_number": "208-782-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047593",
            "telephone_number": "208-535-3637",
            "fax_number": "208-522-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-785-3801"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BINGHAM HEALTHCARE SPECIALTY CLINIC - WASHINGTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BINGHAM MEMORIAL SPECIALTY CLINIC - WASHINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.