NPIMap

Individual provider Active NPI

Aaron Eugene Packham, D.O.

  • Family Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1912356718
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0-1081 Issued in ID
Practice address
512 Pole Line Rd
Twin Falls, ID 83301-6367
Phone
(208) 735-3636
NPI assigned
Jun 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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 0-1081 ID Primary

Addresses

Primary practice location

512 Pole Line Rd
Twin Falls, ID 83301-6367

Mailing address

512 Pole Line Rd
Twin Falls, ID 83301-6367
Phone (208) 735-3636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190327001620 ID Practitioner - Family Practice 4486946266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovative Family Medicine of Idaho PLLCGroup PAC ID 2668820556, 9 clinicians

Practice addresses (Care Compare)

512 Pole Line Rd
Suite 2
Twin Falls, ID 83301-6367
Phone (208) 254-0047

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions14
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0-1081IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Family Medicine of Idaho PLLC Family Medicine CurrentSince Dec 5, 2023 Accepting new patients
St Luke's Clinic LLC Family Medicine CurrentSince Jul 22, 2019 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

512 Pole Line Rd
Twin Falls, ID 83301
Phone (208) 302-3311

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

1411 Falls Ave E
Ste 1301
Twin Falls, ID 83301
Phone (208) 732-0067

775 Pole Line Rd W
Ste 111
Twin Falls, ID 83301

775 Pole Line Rd W
Ste 105
Twin Falls, ID 83301

512 Pole Line Rd
#2
Twin Falls, ID 83301
Phone (208) 254-0047

730 N College Rd
#A
Twin Falls, ID 83301
Phone (208) 814-7300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEJBDD
  • Direct secure messaging: apackham79259@direct.slhs.org

Organizations & group practices 3

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

Hospital & facility affiliations 9

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1912356718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 POLE LINE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016367",
            "telephone_number": "208-735-3636",
            "fax_number": "208-735-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 POLE LINE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016367",
            "telephone_number": "208-735-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKHAM",
        "first_name": "AARON",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "0-1081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.