Active NPI
Amie Michelle Reckon, M.D.
- Family Medicine Physician
- Pocatello, ID
National Provider Identifier
1972942340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MRM-1345
- Practice address
- 465 Memorial Dr
Pocatello, ID 83201-4008 - Phone
- (208) 282-4700
- NPI assigned
- Jun 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MRM-1345 | ID | Primary |
Addresses
Primary practice location
465 Memorial Dr
Pocatello, ID 83201-4008
Mailing address
465 Memorial Dr
Pocatello, ID 83201-4008
Phone (208) 282-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MRM-1345 | ID | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1972942340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 MEMORIAL DR",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014008",
"telephone_number": "208-282-4700",
"fax_number": "208-282-4296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 MEMORIAL DR",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014008",
"telephone_number": "208-282-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECKON",
"first_name": "AMIE",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-19",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "MRM-1345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.