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ASTHMA & ALLERGY OF IDAHO MID LEVEL GROUP
NPI 1265635171
Nurse Practitioner in Twin Falls, ID

Active since June 07, 2007CLIA 13D0672553 · Waiver
1502 LOCUST ST N STE 600, TWIN FALLS, ID 83301(208) 734-6091(208) 734-4654 Get Directions Write a Review

NPPES record last updated: January 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Asthma & Allergy Of Idaho Mid Level Group NPPES

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

ASTHMA & ALLERGY OF IDAHO MID LEVEL GROUP (NPI 1265635171) is a healthcare organization registered as a nurse practitioner in Twin Falls, Idaho and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Andrew Wickern, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1265635171
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameASTHMA & ALLERGY OF IDAHO
Location Address1502 LOCUST ST N STE 600Twin Falls, ID 83301-4164
Mailing Address1502 Locust St N Ste 600Twin Falls, ID 83301-4164 · (208) 734-6091 · Fax (208) 734-4654
Phone(208) 734-6091
Fax(208) 734-4654
Organization SubpartNo
Authorized OfficialAndrew WickernCredentialing Specialist · (208) 734-6091
Enumeration DateJune 7, 2007
Last NPPES UpdateJanuary 14, 2021
NPPES CertifiedJanuary 14, 2021
✔ NPI 1265635171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1502 LOCUST ST N STE 600, Twin Falls, ID 83301
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Other Names 1

Other NameAsthma & Allergy Of Idaho Mid Level Group

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 Waiver 13D0672553

Asthma & Allergy Of Idaho - Twin Falls · Twin Falls, ID
Active · expires Aug 14, 2027
CLIA Number13D0672553
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorRichard E. Henry
Laboratory Phone(208) 734-6092
Laboratory LocationAsthma & Allergy Of Idaho - Twin Falls1502 Locust St N Ste 600, Twin Falls, ID 83301
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.

CLARK JOSEPH WYATT NP-C
Nurse Practitioner (Family)
1502 LOCUST ST N STE 600
TWIN FALLS, ID 83301
Twin Falls County (208) 734-6091
DR. SHAYNE C STOKES MD
Allergy & Immunology
1502 LOCUST ST N STE 600
TWIN FALLS, ID 83301
Twin Falls County (208) 734-6091
ASTHMA & ALLERGY OF IDAHO PLLC
Allergy & Immunology (Allergy)
1502 LOCUST ST N STE 600
TWIN FALLS, ID 83301
Twin Falls County (208) 734-6091
DR. GREGORY MATHEW WICKERN M.D.
Allergy & Immunology (Allergy)
1502 LOCUST ST N STE 600
TWIN FALLS, ID 83301
Twin Falls County (208) 734-6091

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 Asthma & Allergy Of Idaho's NPI number?

The NPI number for Asthma & Allergy Of Idaho is 1265635171. It was assigned to this organization in the NPPES registry on June 7, 2007. The provider is also known as Asthma & Allergy Of Idaho Mid Level Group.

Where is Asthma & Allergy Of Idaho located?

Asthma & Allergy Of Idaho is located at 1502 Locust St N Ste 600, Twin Falls, ID 83301. The listed phone number is (208) 734-6091.

What is Asthma & Allergy Of Idaho's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Asthma & Allergy Of Idaho hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D0672553) is associated with this NPI, valid through August 14, 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 Asthma & Allergy Of Idaho was last updated on January 14, 2021. 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.