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MOMENTUM MEDICAL GROUP OF IDAHO LLC
NPI 1417737594
Family Medicine in Boise, ID

Active since October 04, 2023CLIA 13D2294962 · Waiver
8854 W EMERALD ST STE 275, BOISE, ID 83704(208) 375-3201 Get Directions Write a Review

NPPES record last updated: January 10, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Momentum Medical Group Of Idaho Llc NPPES

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

MOMENTUM MEDICAL GROUP OF IDAHO LLC (NPI 1417737594) is a healthcare organization registered as a family medicine in Boise, Idaho and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through December 3, 2027 and lists Heather Beard, Billing Service, as its authorized official.

NPPES Registry Identity

NPI1417737594
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMOMENTUM MEDICAL GROUP OF IDAHO LLC
Location Address8854 W EMERALD ST STE 275Boise, ID 83704-4860
Mailing Address8854 W Emerald St Ste 140Boise, ID 83704-4845
Phone(208) 375-3201
Organization SubpartNo
Authorized OfficialHeather BeardBilling Service · (208) 880-0883
Enumeration DateOctober 4, 2023
Last NPPES UpdateJanuary 10, 2024
NPPES CertifiedJanuary 10, 2024
✔ NPI 1417737594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
8854 W EMERALD ST STE 275, Boise, ID 83704
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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 13D2294962

Momentum Medical Group Of Idaho LLC · Boise, ID
Active · expires Dec 3, 2027
CLIA Number13D2294962
Laboratory TypePhysician Office
Certificate Effective DateDecember 4, 2025
Certificate Expiration DateDecember 3, 2027
Laboratory DirectorScott N. Schwendiman
Laboratory Phone(208) 999-3034
Laboratory LocationMomentum Medical Group Of Idaho LLC8950 W Emerald St Ste 195, Boise, ID 83704
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Momentum Medical Group Of Idaho LLC's NPI number?

The NPI number for Momentum Medical Group Of Idaho LLC is 1417737594. It was assigned to this organization in the NPPES registry on October 4, 2023.

Where is Momentum Medical Group Of Idaho LLC located?

Momentum Medical Group Of Idaho LLC is located at 8854 W Emerald St Ste 275, Boise, ID 83704. The listed phone number is (208) 375-3201.

What is Momentum Medical Group Of Idaho LLC's specialty?

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

Does Momentum Medical Group Of Idaho LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2294962) is associated with this NPI, valid through December 3, 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 Momentum Medical Group Of Idaho LLC was last updated on January 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.