Rencher Family Practice, PA

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

Organization subpart

No

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.

Title

Physician

Phone

(208) 523-0888

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Timothy Roger Black, DPM

  • Podiatrist
  • Idaho Falls, ID
  • NPI 1578753091
  NPD (past)
• Jerry D Cooper, D.P.M.

  • Podiatrist
  • Idaho Falls, ID
  • NPI 1942299151
  NPD (past)

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": []
}

• Reliance Mental Health
• Reliance Mental Health PC
• Kim Schultz Remien, NP
• Renaissance Ranch
• Renaissance Rehab
• Mark B Rencher, MD
• Nathan S Rencher, D.O.
• Renewed Foundations LLC
• James Resare, LPC
• Restoration Mental Health

• Primary Care Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Primary Care Clinic/Center in Idaho

• 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.