SHOSHONE-BANNOCK COMMUNITY HEALTH CENTER
NPI 1225414519
Clinic/Center in Fort Hall, ID
About Shoshone-bannock Community Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHOSHONE-BANNOCK COMMUNITY HEALTH CENTER (NPI 1225414519) is a healthcare organization registered as a clinic/center in Fort Hall, Idaho and active in the NPI registry since August 2015. The organization holds a CLIA Microscopy certificate valid through June 18, 2027 and lists Melissa M Johnson, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shoshone-bannock Community Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Shoshone-Bannock Community Health Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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) 13D2100443
Shoshone-Bannock Community Health Center · Fort Hall, IDFrequently 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 Shoshone Bannock Tribes, Inc's NPI number?
The NPI number for Shoshone Bannock Tribes, Inc is 1225414519. It was assigned to this organization in the NPPES registry on August 10, 2015. The provider is doing business as Shoshone-Bannock Community Health Center.
Where is Shoshone Bannock Tribes, Inc located?
Shoshone Bannock Tribes, Inc is located at Navajo Drive Bldg 70, Fort Hall, ID 83203. The listed phone number is (208) 478-3995.
What is Shoshone Bannock Tribes, Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Shoshone Bannock Tribes, Inc enrolled in Medicare?
Yes. Shoshone Bannock Tribes, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shoshone Bannock Tribes, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians reassign their Medicare billing to Shoshone Bannock Tribes, Inc, in Clinical Psychologist, Clinical Social Worker, Mental Health Counselor, Nurse Practitioner, Obstetrics/Gynecology and 1 other specialty. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shoshone Bannock Tribes, Inc hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D2100443) is associated with this NPI, valid through June 18, 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 Shoshone Bannock Tribes, Inc was last updated on January 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Shoshone-Bannock Community Health Center · NPI 1225414519
Clinic/Center organization in Fort Hall, Idaho. Organization record, active in the CMS NPPES registry since August 10, 2015.
## Identity
- **NPI:** 1225414519 (Entity type: Organization)
- **Enumerated:** August 10, 2015
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Shoshone Bannock Tribes, Inc
- **Organization subpart:** No
- **Authorized official:** Melissa Johnson, CREDENTIALING MANAGER
## Practice location
- **Address:** NAVAJO DRIVE BLDG 70, Fort Hall, ID 83203-0306
- **Phone:** (208) 478-3995 · **Fax:** (208) 478-4040
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Psychiatry (2), Clinical Psychologist (1); 2 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 19, 2022
- **Other identifiers:** Medicaid 1225414519 (ID)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1225414519) · Data from the CMS NPPES public registry.