RIDGELINE MEDICAL LLC
NPI 1386110963
Family Medicine in Idaho Falls, ID
NPI Status: Active since October 22, 2018
Contact Information
2470 JAFER CT
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 715-9990
Fax: (208) 715-9992
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 13D2162276
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-11-2028
About RIDGELINE MEDICAL LLC
This page provides the complete NPI Profile along with additional information for Ridgeline Medical Llc, a primary care provider established in Idaho Falls, Idaho operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1386110963 assigned on October 2018. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Ridgeline Medical Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Ridgeline Medical Llc. The authorized official of this NPI record is Martin Mangan Do (Owner)
- NPI
- 1386110963
- Provider Legal Name
- RIDGELINE MEDICAL LLC
- Other Organization Name
- RIDGELINE MEDICAL LLC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2470 JAFER CT IDAHO FALLS, ID 83404
- Location Phone
- (208) 715-9990
- Location Fax
- (208) 715-9992
- Mailing Address
- 2429 JAFER CT IDAHO FALLS, ID 83404
- Mailing Phone
- (208) 715-9990
- Mailing Fax
- (208) 715-9992
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-22-2018
- Last Update Date
- 11-01-2021
- Code Navigator
A primary care provider (PCP) like Ridgeline Medical Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 111N00000X | Chiropractic Providers | Chiropractor | |
| 2 | 207QS1201X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 3 | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 4 | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D2162276
- Facility Type
- Physician Office
- Certificate Effective Date
- April 12, 2026
- Certificate Expiration Date
- April 11, 2028
- Laboratory Director
- DANNY SPENCER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ridgeline Medical Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1386110963, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386110963, enumerated as an "organization" on October 22, 2018.
The provider is located at 2470 JAFER CT IDAHO FALLS, ID 83404 and the phone number is (208) 715-9990.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: University of Utah Health Plans. Please consult your insurance carrier or call the provider to verify.
