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INTERMOUNTAIN MEDICAL CLINIC
NPI 1205869310
Family Medicine in Pocatello, ID

Active since July 09, 2006CLIA 13D0520334 · Certificate of Compliance
1951 BENCH RD, SUITE B, POCATELLO, ID 83201(208) 238-1000(238) 238-0009 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Intermountain Medical Clinic NPPES

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

INTERMOUNTAIN MEDICAL CLINIC (NPI 1205869310) is a healthcare organization registered as a family medicine in Pocatello, Idaho and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through September 26, 2026 and lists Shelly Stranski, Administrator, as its authorized official.

NPPES Registry Identity

NPI1205869310
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY PRACTICE GROUP, P.A.
Location Address1951 BENCH RD, SUITE BPocatello, ID 83201-2073
Mailing Address1951 Bench Rd, Suite BPocatello, ID 83201-2073 · (208) 238-1000 · Fax (238) 238-0009
Phone(208) 238-1000
Fax(238) 238-0009
Organization SubpartNo
Authorized OfficialShelly StranskiAdministrator · (208) 238-1000
Enumeration DateJuly 9, 2006
Last NPPES UpdateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1205869310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
1951 BENCH RD, Pocatello, ID 83201
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Other Names 1

Doing Business AsIntermountain Medical Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 13D0520334

Family Practice Group, PA Dba Intermountain Medical Clinic · Pocatello, ID
Active · expires Sep 26, 2026
CLIA Number13D0520334
Laboratory TypePhysician Office
Certificate Effective DateSeptember 27, 2024
Certificate Expiration DateSeptember 26, 2026
Laboratory DirectorAndrew Thayne
Laboratory Phone(208) 238-1000
Laboratory LocationFamily Practice Group, PA Dba Intermountain Medical Clinic1951 Bench Rd Suite B, Pocatello, ID 83201
CLIA data matches this NPI record on: Address 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 18

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

ZACHARY BRYANT WARNOCK M.D.
Family Medicine
1951 BENCH RD, SUITE B
POCATELLO, ID 83201
Bannock County (208) 238-1000
NICOLETTE HAMPTON NP-C
Nurse Practitioner (Family)
1951 BENCH RD, STE B
POCATELLO, ID 83201
Bannock County (208) 238-1000
DNA WITH TINA LLC
Nurse Practitioner (Women's Health)
1951 BENCH RD
POCATELLO, ID 83201
Bannock County (208) 240-4785
BRANDON C MICKELSEN D.O.
Family Medicine
1951 BENCH RD, SUITE B
POCATELLO, ID 83201
Bannock County (208) 238-1000
HIGHLAND PHYSICAL THERAPY LLC
Physical Therapist
1951 BENCH RD, SUITE E
POCATELLO, ID 83201
Bannock County (208) 237-2080
DIAGNOSTIC IMAGING SERVICE OF IDAHO
Radiologic Technologist (Radiography)
1951 BENCH RD, SUITE F
POCATELLO, ID 83201
Bannock County (208) 237-0977
MANDY SMITH PTA
Physical Therapy Assistant
1951 BENCH RD, SUITE E
POCATELLO, ID 83201
Bannock County (208) 237-2080
DR. JOHN ABRAHAM FENSTERMAKER D.O.
Family Medicine
1951 BENCH RD, SUITE B
POCATELLO, ID 83201
Bannock County (208) 238-1000

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 Family Practice Group, P.A.'s NPI number?

The NPI number for Family Practice Group, P.A. is 1205869310. It was assigned to this organization in the NPPES registry on July 9, 2006. The provider is doing business as Intermountain Medical Clinic.

Where is Family Practice Group, P.A. located?

Family Practice Group, P.A. is located at 1951 Bench Rd Suite B, Pocatello, ID 83201. The listed phone number is (208) 238-1000.

What is Family Practice Group, P.A.'s specialty?

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

Does Family Practice Group, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D0520334) is associated with this NPI, valid through September 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Practice Group, P.A. was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.