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COMMUNITY CARE PLLC
NPI 1184647307
Family Medicine in Rexburg, ID

Active since July 26, 2006CLIA 13D0962844 · Certificate of Compliance
72 E MAIN ST, REXBURG, ID 83440(208) 359-1770(208) 359-1780 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Community Care Pllc NPPES

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

COMMUNITY CARE PLLC (NPI 1184647307) is a healthcare organization registered as a family medicine in Rexburg, Idaho and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through October 25, 2027 and lists Ryan Peterson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1184647307
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCOMMUNITY CARE PLLC
Location Address72 E MAIN STRexburg, ID 83440-1926
Mailing Address72 E Main StRexburg, ID 83440-1926 · (208) 359-1770 · Fax (208) 359-1780
Phone(208) 359-1770
Fax(208) 359-1780
Organization SubpartNo
Authorized OfficialRyan PetersonCeo · (208) 525-8448
Enumeration DateJuly 26, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1184647307 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.
72 E MAIN ST, Rexburg, ID 83440
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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

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 of Compliance 13D0962844

Community Care Rexburg · Rexburg, ID
Active · expires Oct 25, 2027
CLIA Number13D0962844
Laboratory TypeRural Health Clinic
Certificate Effective DateOctober 26, 2025
Certificate Expiration DateOctober 25, 2027
Laboratory DirectorDavid F. Daniels
Laboratory Phone(208) 359-1770
Laboratory LocationCommunity Care Rexburg404 N 2nd St E, Rexburg, ID 83440
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

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

TRENT E SHAW PA-C
Physician Assistant (Medical)
72 E MAIN ST
REXBURG, ID 83440
Madison County (208) 359-1770
MOUNTAIN VIEW HOSPITAL LLC
Family Medicine
72 E MAIN ST
REXBURG, ID 83440
Madison County (208) 359-1770
COMMUNITY CARE REXBURG LLC
Clinic/Center
72 E MAIN ST
REXBURG, ID 83440
Madison County (208) 525-8448
DAVID F DANIELS D.O.
Family Medicine
72 E MAIN ST
REXBURG, ID 83440
Madison County (208) 359-1770

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 Community Care PLLC's NPI number?

The NPI number for Community Care PLLC is 1184647307. It was assigned to this organization in the NPPES registry on July 26, 2006.

Where is Community Care PLLC located?

Community Care PLLC is located at 72 E Main St, Rexburg, ID 83440. The listed phone number is (208) 359-1770.

What is Community Care PLLC's specialty?

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

Does Community Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D0962844) is associated with this NPI, valid through October 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Community Care PLLC 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.