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SOUTHERN IDAHO DIABETES EDUCATION PROGRAM
NPI 1154572311
Clinic/Center - Primary Care in Shoshone, ID

Active since October 07, 2008
108 NW RAIL ST, SHOSHONE, ID 83352(208) 944-4747(208) 886-2634 Get Directions Write a Review

NPPES record last updated: October 7, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southern Idaho Diabetes Education Program NPPES

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

SOUTHERN IDAHO DIABETES EDUCATION PROGRAM (NPI 1154572311) is a healthcare organization registered as a primary care in Shoshone, Idaho and active in the NPI registry since October 2008. The organization lists Kathryn Evalena Pike, Sidep Coordinator, as its authorized official.

NPPES Registry Identity

NPI1154572311
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSOUTHERN IDAHO DIABETES EDUCATION PROGRAM
Location Address108 NW RAIL STShoshone, ID 83352
Mailing Address113 S Apple StShoshone, ID 83352-5287 · (208) 886-6222 · Fax (208) 886-2634
Phone(208) 944-4747
Fax(208) 886-2634
Organization SubpartYesParent: Shoshone Family Medical Center
Authorized OfficialKathryn Evalena PikeSidep Coordinator · (208) 944-4747
Enumeration DateOctober 7, 2008
✔ NPI 1154572311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
108 NW RAIL ST, Shoshone, ID 83352
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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 Southern Idaho Diabetes Education Program's NPI number?

The NPI number for Southern Idaho Diabetes Education Program is 1154572311. It was assigned to this organization in the NPPES registry on October 7, 2008.

Where is Southern Idaho Diabetes Education Program located?

Southern Idaho Diabetes Education Program is located at 108 NW Rail St, Shoshone, ID 83352. The listed phone number is (208) 944-4747.

What is Southern Idaho Diabetes Education Program's specialty?

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

When was this NPI record last updated?

The NPPES record for Southern Idaho Diabetes Education Program was last updated on October 7, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.