NPIMap

Organization Active NPI

Rencher Family Practice, PA

  • Primary Care Clinic/Center
  • Idaho Falls, ID
National Provider Identifier
1902048879
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
M4486 Issued in ID
Legal business name
RENCHER FAMILY PRACTICE, PA
Practice address
2610 Channing Way
Idaho Falls, ID 83404-7517
Phone
(208) 523-0888
NPI assigned
Mar 24, 2009
Last updated
Mar 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Authorized official

Name
Dr. Mark B Rencher, M.D.NPI 1649385386
Title
Physician
Phone
(208) 523-0888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X M4486 ID Primary

Addresses

Primary practice location

2610 Channing Way
Idaho Falls, ID 83404-7517

Mailing address

2610 Channing Way
Idaho Falls, ID 83404
Phone (208) 523-0888

National Provider Directory

National Provider Directory

Locations

2610 Channing Way
Idaho Falls, ID 83404
Phone (208) 523-0888

Practitioners & affiliated clinicians

Practitioners 3

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": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1902048879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-523-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047517",
            "telephone_number": "208-523-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENCHER FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "RENCHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-523-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ID",
            "license": "M4486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 24, 2009; 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.