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EMMETT FAMILY MEDICINE AND DIRECT PRIMARY CARE
NPI 1447629555
Family Medicine in Emmett, ID

Active since September 18, 2015CLIA 13D2103854 · Microscopy
2001 E QUAIL RUN RD, EMMETT, ID 83617(208) 365-7131(208) 365-4464 Get Directions Write a Review

NPPES record last updated: January 12, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 12, 2016, Dec 10, 2015 (2 updates tracked since 2015).

About Emmett Family Medicine And Direct Primary Care NPPES

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

EMMETT FAMILY MEDICINE AND DIRECT PRIMARY CARE (NPI 1447629555) is a healthcare organization registered as a family medicine in Emmett, Idaho and active in the NPI registry since September 2015. The organization holds a CLIA Microscopy certificate valid through October 20, 2027 and lists Ryan Earl White, Clinic Administrator, as its authorized official.

NPPES Registry Identity

NPI1447629555
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePETRIE WHITE FAMILY MEDICINE OF IDAHO
Location Address2001 E QUAIL RUN RDEmmett, ID 83617-5059
Mailing Address2001 E Quail Run RdEmmett, ID 83617-5059 · (208) 365-7131 · Fax (208) 365-4464
Phone(208) 365-7131
Fax(208) 365-4464
Organization SubpartNo
Authorized OfficialRyan Earl WhiteClinic Administrator · (208) 365-7131
Enumeration DateSeptember 18, 2015
Last NPPES UpdateJanuary 12, 20162 updates tracked since enumeration
✔ NPI 1447629555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ID · M7802
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.
2001 E QUAIL RUN RD, Emmett, ID 83617
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Other Names 1

Doing Business AsEmmett Family Medicine And Direct Primary Care

Other Identifiers 3

Medicaid805196400ID
Medicare UPINH36248ID
Medicare PIN11063077

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

Accepted Insurance

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

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 for Provider-Performed Microscopy Procedures (PPMP) 13D2103854

Emmett Family Medicine & Direct Primary Care · Emmett, ID
Active · expires Oct 20, 2027
CLIA Number13D2103854
Laboratory TypeCommunity Clinic
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorJennifer L. Petrie
Laboratory Phone(208) 365-7131
Laboratory LocationEmmett Family Medicine & Direct Primary Care2001 E Quail Run Rd, Emmett, ID 83617
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MICHELE MILES PA-C,MS
Physician Assistant
2001 E QUAIL RUN RD
EMMETT, ID 83617
Gem County (208) 365-7131
JENNIFER PETRIE MD
Family Medicine
2001 E QUAIL RUN RD
EMMETT, ID 83617
Gem County (208) 365-7131

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 Petrie White Family Medicine Of Idaho's NPI number?

The NPI number for Petrie White Family Medicine Of Idaho is 1447629555. It was assigned to this organization in the NPPES registry on September 18, 2015. The provider is doing business as Emmett Family Medicine And Direct Primary Care.

Where is Petrie White Family Medicine Of Idaho located?

Petrie White Family Medicine Of Idaho is located at 2001 E Quail Run Rd, Emmett, ID 83617. The listed phone number is (208) 365-7131.

What is Petrie White Family Medicine Of Idaho's specialty?

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

Does Petrie White Family Medicine Of Idaho hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D2103854) is associated with this NPI, valid through October 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Petrie White Family Medicine Of Idaho accept?

Health plans from Moda Health Plan, Inc. list Petrie White Family Medicine Of Idaho 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 Petrie White Family Medicine Of Idaho was last updated on January 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.