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POCATELLO (ISU) FAMILY MEDICINE
NPI 1578505335
Clinic/Center in Pocatello, ID

Active since June 12, 2006
651 MEMORIAL DR, POCATELLO, ID 83201(208) 282-4700(208) 282-4969 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pocatello (isu) Family Medicine NPPES

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

POCATELLO (ISU) FAMILY MEDICINE (NPI 1578505335) is a healthcare organization registered as a clinic/center in Pocatello, Idaho and active in the NPI registry since June 2006. The organization lists Johnathan Wilker, Vp Finance & Cfo, as its authorized official.

NPPES Registry Identity

NPI1578505335
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePORTNEUF MEDICAL CENTER
Location Address651 MEMORIAL DRPocatello, ID 83201-4071
Mailing Address651 Memorial DrPocatello, ID 83201-4071 · (208) 282-4700 · Fax (208) 282-4969
Phone(208) 282-4700
Fax(208) 282-4969
Organization SubpartNo
Authorized OfficialJohnathan WilkerVp Finance & Cfo · (208) 239-1020
Enumeration DateJune 12, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1578505335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in ID · H12
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
651 MEMORIAL DR, Pocatello, ID 83201
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Other Names 1

Other NamePocatello (isu) Family Medicine

Other Providers at the Same Location NPPES 20

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

KENNETH RYAN MD
Emergency Medicine
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
PORTNEUF MEDICAL CENTER
Home Health
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
JACOB DELAROSA MD
Internal Medicine (Cardiovascular Disease)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
POCATELLO HEALTH SERVICES, LLC
General Acute Care Hospital
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2065
PHS MD #1, LLC
Clinic/Center (Primary Care)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2110
RANDALL FOWLER MD
Emergency Medicine
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1000
ROBERTA LOUISE COLE CRT
Respiratory Therapist, Certified (General Care)
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-1372
PORTNEUF MEDICAL CENTER
General Acute Care Hospital
651 MEMORIAL DR
POCATELLO, ID 83201
Bannock County (208) 239-2110

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 Portneuf Medical Center's NPI number?

The NPI number for Portneuf Medical Center is 1578505335. It was assigned to this organization in the NPPES registry on June 12, 2006. The provider is also known as Pocatello (isu) Family Medicine.

Where is Portneuf Medical Center located?

Portneuf Medical Center is located at 651 Memorial Dr, Pocatello, ID 83201. The listed phone number is (208) 282-4700.

What is Portneuf Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Portneuf Medical Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.