ACTIVE FAMILY HEALTHCARE PLLC - NPI 1063764462 - Family Medicine in Coeur D Alene, ID

Q: What is Active Family Healthcare PLLC's NPI number?

The NPI number for Active Family Healthcare PLLC is 1063764462. It was assigned to this organization in the NPPES registry on October 9, 2012.

Q: What is Active Family Healthcare PLLC's specialty?

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

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About Active Family Healthcare Pllc NPPES

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

ACTIVE FAMILY HEALTHCARE PLLC (NPI 1063764462) is a healthcare organization registered as a family medicine in Coeur D Alene, Idaho and active in the NPI registry since October 2012. The organization holds a CLIA Microscopy certificate valid through September 8, 2027 and lists Jennifer Fletcher, Owner Nurse Practioner, as its authorized official.

NPPES Registry Identity

NPI1063764462

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameACTIVE FAMILY HEALTHCARE PLLC

Location Address919 W CANFIELD AVECoeur D Alene, ID 83815-9764

Mailing Address919 W Canfield AveCoeur D Alene, ID 83815-9764 · (208) 758-0560 · Fax (208) 762-5424

Phone(208) 758-0560

Fax(208) 762-5424

Organization SubpartNo

Authorized OfficialJennifer FletcherOwner Nurse Practioner · (208) 758-0560

Enumeration DateOctober 9, 2012

Last NPPES UpdateMarch 3, 20253 updates tracked since enumeration

NPPES CertifiedMarch 3, 2025

✔ NPI 1063764462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

919 W CANFIELD AVE, Coeur D Alene, ID 83815

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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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

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) 13D2065341

Active Family Healthcare · Coeur D Alene, ID

Active · expires Sep 8, 2027

CLIA Number13D2065341

Laboratory TypePhysician Office

Certificate Effective DateSeptember 9, 2025

Certificate Expiration DateSeptember 8, 2027

Laboratory DirectorJennifer S. Fletcher

Laboratory Phone(208) 758-0560

Laboratory LocationActive Family Healthcare919 W Canfield Ave, Coeur D Alene, ID 83815

CLIA data matches this NPI record on: Address Name Phone

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 7

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

JENNIFER FLETCHER NP

Nurse Practitioner