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POCATELLO WELLNESS CLINIC, LLC
NPI 1437615952
Nurse Practitioner - Family in Pocatello, ID

Active since February 20, 2019
1155 YELLOWSTONE AVE, STE D, POCATELLO, ID 83201(208) 637-9610(208) 238-6162 Get Directions Write a Review

NPPES record last updated: April 23, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 23, 2024, Mar 17, 2020, Feb 20, 2019 (3 updates tracked since 2019).

About Pocatello Wellness Clinic, Llc NPPES

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

POCATELLO WELLNESS CLINIC, LLC (NPI 1437615952) is a healthcare organization registered as a family in Pocatello, Idaho and active in the NPI registry since February 2019. The organization lists Dustin Reno, Owner, as its authorized official.

NPPES Registry Identity

NPI1437615952
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePOCATELLO WELLNESS CLINIC, LLC
Location Address1155 YELLOWSTONE AVE, STE DPocatello, ID 83201-4369
Mailing Address1155 Yellowstone Ave, Ste DPocatello, ID 83201-4369 · (208) 637-9610 · Fax (208) 238-6162
Phone(208) 637-9610
Fax(208) 238-6162
Organization SubpartNo
Authorized OfficialDustin RenoOwner · (208) 637-9610
Enumeration DateFebruary 20, 2019
Last NPPES UpdateApril 23, 20243 updates tracked since enumeration
NPPES CertifiedMarch 17, 2020
✔ NPI 1437615952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1155 YELLOWSTONE AVE, Pocatello, ID 83201
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pocatello Wellness Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Pocatello Wellness Clinic, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Kayloni Christensen, NP
Nurse Practitioner
NPI 1134987597
1155 YELLOWSTONE AVE STE D
Pocatello, ID 83201
(208) 637-9610
✔ PECOS✔ Accepts MedicareSame address
Dustin Reno, NP-C
Nurse Practitioner
NPI 1568906865
1155 YELLOWSTONE AVE STE D
Pocatello, ID 83201
(208) 637-9610
✔ PECOS✔ Accepts MedicareSame address
Mckenzie Hoggan, BSN, MSN, WHNP-BC
Nurse Practitioner
NPI 1437083755
1155 YELLOWSTONE AVE STE D
Pocatello, ID 83201
(208) 637-9610
✔ PECOSSame address
Jason Knighton, NP-C
Nurse Practitioner
NPI 1285199869
2928 MICHELLE ST
Pocatello, ID 83201
(208) 244-0997
✔ PECOS✔ Accepts Medicare2.3 mi

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 Pocatello Wellness Clinic, LLC's NPI number?

The NPI number for Pocatello Wellness Clinic, LLC is 1437615952. It was assigned to this organization in the NPPES registry on February 20, 2019.

Where is Pocatello Wellness Clinic, LLC located?

Pocatello Wellness Clinic, LLC is located at 1155 Yellowstone Ave Ste D, Pocatello, ID 83201. The listed phone number is (208) 637-9610.

What is Pocatello Wellness Clinic, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Pocatello Wellness Clinic, LLC enrolled in Medicare?

Yes. Pocatello Wellness Clinic, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pocatello Wellness Clinic, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Pocatello Wellness Clinic, 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. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Pocatello Wellness Clinic, LLC accept?

Health plans from Moda Health Plan, Inc. and Molina Healthcare list Pocatello Wellness Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pocatello Wellness Clinic, LLC was last updated on April 23, 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.