EAST IDAHO WOUND CARE LLC
NPI 1407748510
Nurse Practitioner - Family in Idaho Falls, ID
About East Idaho Wound Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST IDAHO WOUND CARE LLC (NPI 1407748510) is a healthcare organization registered as a family in Idaho Falls, Idaho and active in the NPI registry since July 2025. The organization lists Justin Kyler Croft, Np, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 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)
East Idaho Wound Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to East Idaho Wound Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 East Idaho Wound Care LLC's NPI number?
The NPI number for East Idaho Wound Care LLC is 1407748510. It was assigned to this organization in the NPPES registry on July 15, 2025.
Where is East Idaho Wound Care LLC located?
East Idaho Wound Care LLC is located at 1005 Terry Dr, Idaho Falls, ID 83404. The listed phone number is (208) 541-8879.
What is East Idaho Wound Care LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is East Idaho Wound Care LLC enrolled in Medicare?
Yes. East Idaho Wound Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through East Idaho Wound Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to East Idaho Wound Care LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for East Idaho Wound Care LLC was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# East Idaho Wound Care Llc · NPI 1407748510
Family organization in Idaho Falls, Idaho. Organization record, active in the CMS NPPES registry since July 15, 2025.
## Identity
- **NPI:** 1407748510 (Entity type: Organization)
- **Enumerated:** July 15, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Justin Croft, NP
## Practice location
- **Address:** 1005 TERRY DR, Idaho Falls, ID 83404-5122
- **Phone:** (208) 541-8879
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1407748510) · Data from the CMS NPPES public registry.