BLUE LAKES GASTROENTEROLOGY, PLLC
NPI 1144267022
Internal Medicine - Gastroenterology in Twin Falls, ID

Q: What is Blue Lakes Gastroenterology, PLLC's NPI number?

The NPI number for Blue Lakes Gastroenterology, PLLC is 1144267022. It was assigned to this organization in the NPPES registry on June 1, 2006.

Q: What is Blue Lakes Gastroenterology, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Active since June 01, 2006

775 POLE LINE RD W, SUITE 203, TWIN FALLS, ID 83301(208) 814-8300(208) 733-8970 Get Directions Write a Review

NPPES record last updated: March 9, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Blue Lakes Gastroenterology, Pllc NPPES

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

BLUE LAKES GASTROENTEROLOGY, PLLC (NPI 1144267022) is a healthcare organization registered as a gastroenterology in Twin Falls, Idaho and active in the NPI registry since June 2006. The organization lists Robert Ward, Physician, as its authorized official.

NPPES Registry Identity

NPI1144267022

Entity TypeOrganization

Primary Taxonomy207RG0100X

Legal Business NameBLUE LAKES GASTROENTEROLOGY, PLLC

Location Address775 POLE LINE RD W, SUITE 203Twin Falls, ID 83301-5814

Mailing Address775 Pole Line Rd W, Suite 203Twin Falls, ID 83301-5814 · (208) 814-8300 · Fax (208) 733-8970

Phone(208) 814-8300

Fax(208) 733-8970

Organization SubpartNo

Authorized OfficialRobert WardPhysician · (208) 814-8300

Enumeration DateJune 1, 2006

Last NPPES UpdateMarch 9, 2013

✔ NPI 1144267022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in ID · M6665

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

775 POLE LINE RD W, Twin Falls, ID 83301

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Other Identifiers 4

OtherCJ6218ID · Rr Medicare

Medicare PIN1370041ID

Medicare NSC4477100001ID

Medicaid806237600ID

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

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.

DR. MITCHELL JACKSON MOFFITT M.D.

Pediatrics

775 POLE LINE RD W, SUITE 111
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8000

DR. RONALD WILLIAM BLAIR D.O.

Surgery

775 POLE LINE RD W, SUITE 212
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8400

JOHN A BAKER M.D.

Internal Medicine

775 POLE LINE RD W, SUITE 302
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8600

KOVIC SHANE BAILEY DO

Family Medicine

775 POLE LINE RD W
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8000

DANIEL G PREUCIL M.D.

Family Medicine

775 POLE LINE RD W, SUITE 105
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8000

BRUCE C MCCOMAS M.D.

Surgery

775 POLE LINE RD W, SUITE 212
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8400

PHYSICIAN CENTER A PROFESSIONAL COMPANY MID LEVEL

Family Medicine

775 POLE LINE RD W, SUITE 105 & 111
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8000

HEATHER MERTEN KOHRING FNP-C

Nurse Practitioner

775 POLE LINE RD W, SUITE 203
TWIN FALLS, ID 83301

Twin Falls County (208) 814-8300

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 Blue Lakes Gastroenterology, PLLC's NPI number?

The NPI number for Blue Lakes Gastroenterology, PLLC is 1144267022. It was assigned to this organization in the NPPES registry on June 1, 2006.

Where is Blue Lakes Gastroenterology, PLLC located?

Blue Lakes Gastroenterology, PLLC is located at 775 Pole Line Rd W Suite 203, Twin Falls, ID 83301. The listed phone number is (208) 814-8300.

What is Blue Lakes Gastroenterology, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

When was this NPI record last updated?

The NPPES record for Blue Lakes Gastroenterology, PLLC was last updated on March 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.