EMMETT FAMILY MEDICINE AND DIRECT PRIMARY CARE
NPI 1447629555
Family Medicine in Emmett, ID
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
Specialties & Licenses
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted 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)
Emmett Family Medicine And Direct Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Emmett Family Medicine And Direct Primary Care, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, IDFrequently 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.
Is Petrie White Family Medicine Of Idaho enrolled in Medicare?
Yes. Petrie White Family Medicine Of Idaho is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Petrie White Family Medicine Of Idaho?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Petrie White Family Medicine Of Idaho, in Family Practice and Nurse Practitioner. 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Emmett Family Medicine And Direct Primary Care · NPI 1447629555
Family Medicine organization in Emmett, Idaho. Organization record, active in the CMS NPPES registry since September 18, 2015.
## Identity
- **NPI:** 1447629555 (Entity type: Organization)
- **Enumerated:** September 18, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Petrie White Family Medicine Of Idaho
- **Organization subpart:** No
- **Authorized official:** Ryan White, CLINIC ADMINISTRATOR
## Practice location
- **Address:** 2001 E QUAIL RUN RD, Emmett, ID 83617-5059
- **Phone:** (208) 365-7131 · **Fax:** (208) 365-4464
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 12, 2016
- **Other identifiers:** Medicaid 805196400 (ID); Medicare UPIN H36248 (ID); Medicare PIN 11063077
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1447629555) · Data from the CMS NPPES public registry.