Individual provider Active NPI

Paul Beckett, DO

  • Family Medicine Physician
  • Blackfoot, ID
National Provider Identifier
1831115757
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-0412 Issued in IN
Practice address
1441 Parkway Dr
Blackfoot, ID 83221-1667
Phone
(208) 785-2600
NPI assigned
Jul 14, 2006
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-0412 IN 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061013000590 ID Practitioner - Family Practice 8729057161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVH BMC LLCGroup PAC ID 2961791991, 14 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
O-0412INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVH BMC LLC Family Medicine CurrentSince May 1, 2016 Accepting new patients
MVH BMC LLC Family Medicine Current Accepting new patients
MVH BMC LLC Family Medicine CurrentSince May 1, 2016 Accepting new patients
Emergency Physicians of Indiana PC Past Accepting new patients

Locations

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

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

210 S Emerson Ave
Shelley, ID 83274
Phone (208) 357-7404

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1831115757",
    "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": {
        "last_name": "BECKETT",
        "first_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "O-0412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

Verify at the official NPI Registry.