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IDAHO ORTHOPEDIC & SPORTS CLINIC PA
NPI 1538238571
Clinic/Center - Multi-Specialty in Pocatello, ID

Active since November 06, 2006
560 MEMORIAL DR, POCATELLO, ID 83201(208) 234-1969(208) 233-5033 Get Directions Write a Review

NPPES record last updated: July 30, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Idaho Orthopedic & Sports Clinic Pa NPPES

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

IDAHO ORTHOPEDIC & SPORTS CLINIC PA (NPI 1538238571) is a healthcare organization registered as a multi-specialty in Pocatello, Idaho and active in the NPI registry since November 2006. The organization lists Ryan Hall, Administrator, as its authorized official.

NPPES Registry Identity

NPI1538238571
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameIDAHO ORTHOPEDIC & SPORTS CLINIC PA
Location Address560 MEMORIAL DRPocatello, ID 83201-4073
Mailing Address560 Memorial DrPocatello, ID 83201-4073 · (208) 234-1969 · Fax (208) 233-5033
Phone(208) 234-1969
Fax(208) 233-5033
Organization SubpartNo
Authorized OfficialRyan HallAdministrator · (208) 234-1960
Enumeration DateNovember 6, 2006
Last NPPES UpdateJuly 30, 2015
✔ NPI 1538238571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
560 MEMORIAL DR, Pocatello, ID 83201
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Other Identifiers 2

Medicaid805136500ID
Medicare ID-Type Unspecified1374081ID

Other Providers at the Same Location NPPES 12

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

EDWARD T SCHWARZE MPT
Physical Therapist
560 MEMORIAL DR, SUITE C
POCATELLO, ID 83201
Bannock County (208) 233-4648
BMH INC.
Orthopaedic Surgery (Sports Medicine)
560 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 234-1960
MCKENZIE JEMMETT SLP
Speech-Language Pathologist
560 MEMORIAL DR, STE C
POCATELLO, ID 83201
Bannock County (208) 904-1112
DR. KENNETH E NEWHOUSE MD
Orthopaedic Surgery
560 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 234-1960
DEREK EDDIE PA-C
Physician Assistant (Medical)
560 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 234-1960
FRANK TODD DIMICK ATC, LAT, LPTA
Physical Therapy Assistant
560 MEMORIAL DR, SUITE C
POCATELLO, ID 83201
Bannock County (208) 232-4267
IDAHO ORTHOPAEDICS AND SPORTS CLINIC
Durable Medical Equipment & Medical Supplies
560 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 234-1969
STEVEN L NELSON PA-C
Physician Assistant (Surgical)
560 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 234-1960

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 Idaho Orthopedic & Sports Clinic PA's NPI number?

The NPI number for Idaho Orthopedic & Sports Clinic PA is 1538238571. It was assigned to this organization in the NPPES registry on November 6, 2006.

Where is Idaho Orthopedic & Sports Clinic PA located?

Idaho Orthopedic & Sports Clinic PA is located at 560 Memorial Dr, Pocatello, ID 83201. The listed phone number is (208) 234-1969.

What is Idaho Orthopedic & Sports Clinic PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Idaho Orthopedic & Sports Clinic PA was last updated on July 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.