CORE MEDICINE OF IDAHO
NPI 1043927882
Clinic/Center - Primary Care in Caldwell, ID

Active since November 01, 2022CLIA 13D2287103 · Microscopy
4605 ENTERPRISE WAY, STE 101, CALDWELL, ID 83605(208) 353-7518 Get Directions Write a Review

NPPES record last updated: January 16, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 22, 2023, Jan 6, 2023, Nov 14, 2022 and 1 more (4 updates tracked since 2022).

About Core Medicine Of Idaho NPPES

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

CORE MEDICINE OF IDAHO (NPI 1043927882) is a healthcare organization registered as a primary care in Caldwell, Idaho and active in the NPI registry since November 2022. The organization holds a CLIA Microscopy certificate valid through August 8, 2027 and lists Sophie Rath, Mananger, as its authorized official.

NPPES Registry Identity

NPI1043927882
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCORE MEDICINE IDAHO, LLC
Location Address4605 ENTERPRISE WAY, STE 101Caldwell, ID 83605-8360
Mailing Address2667 E Gala Ct Ste 130Meridian, ID 83642-2788 · (208) 795-5090
Organization SubpartNo
Authorized OfficialSophie RathMananger · (208) 795-5090
Enumeration DateNovember 1, 2022
Last NPPES UpdateJanuary 16, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2024
✔ NPI 1043927882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
4605 ENTERPRISE WAY, Caldwell, ID 83605

Other Names 1

Doing Business AsCore Medicine Of Idaho

Other Identifiers 1

Medicaid1295734796ID

Accepted 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)

Core Medicine Of Idaho is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Core Medicine Of Idaho, 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 (6)

Nurse Practitioner
NPI 1780092130
4605 ENTERPRISE WAY STE 101
Caldwell, ID 83605
(208) 795-5090
✔ PECOSSame address
Nurse Practitioner
NPI 1841456191
512 E ELM ST
Caldwell, ID 83605
(208) 468-5925
✔ PECOS✔ Accepts Medicare2.7 mi
Nurse Practitioner
NPI 1891264545
1510 12TH AVE RD STE 200
Nampa, ID 83686
(208) 302-6800
✔ PECOS✔ Accepts Medicare8.2 mi
Nurse Practitioner
NPI 1053850164
124 5TH ST
Wilder, ID 83676
(208) 482-7430
✔ PECOS✔ Accepts Medicare14 mi
Nurse Practitioner
NPI 1861794026
3183 N COLE RD
Boise, ID 83704
(208) 322-4555
✔ PECOS✔ Accepts Medicare19 mi
Nurse Practitioner
NPI 1477958494
1219 SW 4TH AVE UNIT 1
Ontario, OR 97914
(541) 889-2668
✔ PECOS✔ Accepts Medicare30 mi

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

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 13D2287103

Core Medicine Of Idaho LLC · Caldwell, ID
Active · expires Aug 8, 2027
CLIA Number13D2287103
Laboratory TypePhysician Office
Certificate Effective DateAugust 9, 2025
Certificate Expiration DateAugust 8, 2027
Laboratory DirectorAlex Casebolt
Laboratory Phone(208) 508-0345
Laboratory LocationCore Medicine Of Idaho LLC4605 Enterprise Way Ste 101, Caldwell, ID 83605
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Core Medicine Idaho, LLC's NPI number?

The NPI number for Core Medicine Idaho, LLC is 1043927882. It was assigned to this organization in the NPPES registry on November 1, 2022. The provider is doing business as Core Medicine Of Idaho.

Where is Core Medicine Idaho, LLC located?

Core Medicine Idaho, LLC is located at 4605 Enterprise Way Ste 101, Caldwell, ID 83605. The listed phone number is (208) 353-7518.

What is Core Medicine Idaho, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Core Medicine Idaho, LLC enrolled in Medicare?

Yes. Core Medicine Idaho, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Core Medicine Idaho, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Core Medicine Idaho, LLC. 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.

Does Core Medicine Idaho, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D2287103) is associated with this NPI, valid through August 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Core Medicine Idaho, LLC accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare and Select Health list Core Medicine Idaho, LLC 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 Core Medicine Idaho, LLC was last updated on January 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.