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PORTNEUF HOME HEALTH CARE
NPI 1053353227
Home Health in Pocatello, ID

Active since June 12, 2006CLIA Certified · 2 labs
651 MEMORIAL DR, POCATELLO, ID 83201(208) 239-1000(208) 239-0408 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Portneuf Home Health Care NPPES

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

PORTNEUF HOME HEALTH CARE (NPI 1053353227) is a healthcare organization registered as a home health in Pocatello, Idaho and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates and lists Johnathan Wilker, Vp Finance & Cfo, as its authorized official.

NPPES Registry Identity

NPI1053353227
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NamePORTNEUF MEDICAL CENTER
Location Address651 MEMORIAL DRPocatello, ID 83201-4071
Mailing Address651 Memorial DrPocatello, ID 83201-4071 · (208) 239-1000 · Fax (208) 239-0408
Phone(208) 239-1000
Fax(208) 239-0408
Organization SubpartNo
Authorized OfficialJohnathan WilkerVp Finance & Cfo · (208) 239-1020
Enumeration DateJune 12, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1053353227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in ID · HH106
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
651 MEMORIAL DR, Pocatello, ID 83201
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Other Names 1

Other NamePortneuf Home Health Care

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 Accreditation 13D0520361

Portneuf Medical Center Laboratory · Pocatello, ID
Active · expires Jan 2, 2027
CLIA Number13D0520361
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Kristopher Mcgee
Laboratory Phone(208) 239-1671
Laboratory LocationPortneuf Medical Center Laboratory777 Hospital Way, Pocatello, ID 83201
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D2049345

Portneuf Medical Center Specialized Family Medicine · Pocatello, ID
Active · expires Nov 4, 2026
CLIA Number13D2049345
Laboratory TypePhysician Office
Certificate Effective DateNovember 5, 2024
Certificate Expiration DateNovember 4, 2026
Laboratory DirectorJordan L. Bailey
Laboratory Phone(208) 269-7147
Laboratory LocationPortneuf Medical Center Specialized Family Medicine151 N 4th Ave #b, Pocatello, ID 83201
CLIA data matches this NPI record on: 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.

Other Providers at the Same Location NPPES 20

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

KENNETH RYAN MD
Emergency Medicine
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
JACOB DELAROSA MD
Internal Medicine (Cardiovascular Disease)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
POCATELLO HEALTH SERVICES, LLC
General Acute Care Hospital
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2065
PHS MD #1, LLC
Clinic/Center (Primary Care)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2110
RANDALL FOWLER MD
Emergency Medicine
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
ROBERTA LOUISE COLE CRT
Respiratory Therapist, Certified (General Care)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1372
PORTNEUF MEDICAL CENTER
General Acute Care Hospital
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2110
DAVID PAUL BRIZZEE
Family Medicine
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 282-4700

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 Portneuf Medical Center's NPI number?

The NPI number for Portneuf Medical Center is 1053353227. It was assigned to this organization in the NPPES registry on June 12, 2006. The provider is also known as Portneuf Home Health Care.

Where is Portneuf Medical Center located?

Portneuf Medical Center is located at 651 Memorial Dr, Pocatello, ID 83201. The listed phone number is (208) 239-1000.

What is Portneuf Medical Center's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Portneuf Medical Center 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 Portneuf Medical Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.