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COMMUNITY CARE, PLLC
NPI 1003088782
Family Medicine in Pocatello, ID

Active since April 02, 2008CLIA Certified · 2 labs
1595 YELLOWSTONE AVE, POCATELLO, ID 83201(208) 233-0032 Get Directions Write a Review

NPPES record last updated: August 12, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Community Care, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COMMUNITY CARE, PLLC (NPI 1003088782) is a healthcare organization registered as a family medicine in Pocatello, Idaho and active in the NPI registry since April 2008. The organization holds 2 active CLIA laboratory certificates and lists Ryan L Peterson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003088782
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCOMMUNITY CARE, PLLC
Location Address1595 YELLOWSTONE AVEPocatello, ID 83201
Mailing Address1595 Yellowstone AvePocatello, ID 83201 · (208) 233-0032
Phone(208) 233-0032
Organization SubpartNo
Authorized OfficialRyan L PetersonCeo · (208) 525-8448
Enumeration DateApril 2, 2008
Last NPPES UpdateAugust 12, 2010
✔ NPI 1003088782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysician AssistantTaxonomy 363A00000X
1595 YELLOWSTONE AVE, Pocatello, ID 83201
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 13D1085881

Community Care Pocatello · Pocatello, ID
Active · expires Oct 22, 2026
CLIA Number13D1085881
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2024
Certificate Expiration DateOctober 22, 2026
Laboratory DirectorEthan L. Mccarty
Laboratory Phone(208) 233-0032
Laboratory LocationCommunity Care Pocatello1595 Yellowstone Ave, Pocatello, ID 83201
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 13D0926381

Community Care Idaho Falls East · Idaho Falls, ID
Active · expires Feb 5, 2028
CLIA Number13D0926381
Laboratory TypePhysician Office
Certificate Effective DateFebruary 6, 2026
Certificate Expiration DateFebruary 5, 2028
Laboratory DirectorEthan L. Mccarty
Laboratory Phone(208) 525-8448
Laboratory LocationCommunity Care Idaho Falls East2725 Channing Way, Idaho Falls, ID 83404
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMMUNITY CARE POCATELLO PLLC
Clinic/Center (Urgent Care)
1595 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 233-0032
CC POCATELLO LLC
Family Medicine
1595 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 233-0032
MOUNTAIN VIEW HOSPITAL LLC
Pain Medicine (Pain Medicine)
1595 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 522-7246
MR. JUSTUS FLIN LAMBSON PA-C
Physician Assistant
1595 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 233-0032
AMBER RAE HAYS
Physician Assistant
1595 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 233-0032

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Community Care, PLLC's NPI number?

The NPI number for Community Care, PLLC is 1003088782. It was assigned to this organization in the NPPES registry on April 2, 2008.

Where is Community Care, PLLC located?

Community Care, PLLC is located at 1595 Yellowstone Ave, Pocatello, ID 83201. The listed phone number is (208) 233-0032.

What is Community Care, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Community Care, PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Community Care, PLLC was last updated on August 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.