Pocatello Community Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

POCATELLO COMMUNITY CHARTER SCHOOL

Practice address

995 S Arthur Ave
Pocatello, ID 83204-3400

Phone

(208) 478-2522

NPI assigned

Oct 8, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Todd Levesque

Title

Systems Manager

Phone

(208) 922-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1992956841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 S ARTHUR AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043400",
            "telephone_number": "208-478-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 S ARTHUR AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043400",
            "telephone_number": "208-478-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO COMMUNITY CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "LEVESQUE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "SYSTEMS MANAGER",
        "authorized_official_telephone_number": "208-922-9300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807649400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pocatello Cardiology Associates
• Pocatello Children & Adolescent Clinic
• Pocatello Children'S Clinic
• Pocatello Chubbuck School District #25
• Pocatello Clinic of Internal Medicine PA
• Pocatello Dental Excellence
• Pocatello Family Medicine
• Pocatello Free Clinic
• Pocatello Health Services, Inc.
• Pocatello Health Services, Inc.

• Local Education Agency (LEA) in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Local Education Agency (LEA) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.