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IDAHO ALLERGY & ASTHMA CLINIC PA
NPI 1003949298
Allergy & Immunology in Idaho Falls, ID

Active since March 14, 2007
3422 S 15TH E, IDAHO FALLS, ID 83404(208) 529-9292(208) 523-2397 Get Directions Write a Review

NPPES record last updated: June 21, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Idaho Allergy & Asthma Clinic Pa NPPES

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

IDAHO ALLERGY & ASTHMA CLINIC PA (NPI 1003949298) is a healthcare organization registered as an allergy & immunology in Idaho Falls, Idaho and active in the NPI registry since March 2007. The organization lists Wendell E Petty, President, as its authorized official.

NPPES Registry Identity

NPI1003949298
Entity TypeOrganization
Primary Taxonomy207K00000X
Legal Business NameIDAHO ALLERGY & ASTHMA CLINIC PA
Location Address3422 S 15TH EIdaho Falls, ID 83404-8262
Mailing Address3422 S 15th EIdaho Falls, ID 83404-8262 · (208) 529-9292 · Fax (208) 523-2397
Phone(208) 529-9292
Fax(208) 523-2397
Organization SubpartNo
Authorized OfficialWendell E PettyPresident · (208) 529-9292
Enumeration DateMarch 14, 2007
Last NPPES UpdateJune 21, 2019
✔ NPI 1003949298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
3422 S 15TH E, Idaho Falls, ID 83404
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Other Identifiers 4

Other0000100004631ID · Blue Shield
Other8N147ID · Blue Cross
OtherDG4709ID · Railroad Medicare
Medicaid002516900ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Idaho Allergy & Asthma Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Idaho Allergy & Asthma Clinic PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Valerie Ward
Nurse Practitioner
NPI 1255291522
3422 S 15TH E
Idaho Falls, ID 83404
(208) 529-9292
✔ PECOSSame address
David Petty, D.O.
Allergy/Immunology
NPI 1376877795
3422 S 15TH E
Idaho Falls, ID 83404
(208) 529-9292
✔ PECOS✔ Accepts Medicare0.1 mi
Wendell Petty, M.D.
Allergy/Immunology
NPI 1457312308
3422 S 15TH E
Idaho Falls, ID 83404
(208) 529-9292
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Idaho Allergy & Asthma Clinic PA's NPI number?

The NPI number for Idaho Allergy & Asthma Clinic PA is 1003949298. It was assigned to this organization in the NPPES registry on March 14, 2007.

Where is Idaho Allergy & Asthma Clinic PA located?

Idaho Allergy & Asthma Clinic PA is located at 3422 S 15th E, Idaho Falls, ID 83404. The listed phone number is (208) 529-9292.

What is Idaho Allergy & Asthma Clinic PA's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Is Idaho Allergy & Asthma Clinic PA enrolled in Medicare?

Yes. Idaho Allergy & Asthma Clinic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Idaho Allergy & Asthma Clinic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Idaho Allergy & Asthma Clinic PA, in Allergy/Immunology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Idaho Allergy & Asthma Clinic PA accept?

Health plans from Moda Health Plan, Inc. and University of Utah Health Plans list Idaho Allergy & Asthma Clinic PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Idaho Allergy & Asthma Clinic PA was last updated on June 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.