FALL CREEK SKIN AND HEALTH PLLC
NPI 1629247093
Physician Assistant - Medical in Rexburg, ID

Q: What is Fall Creek Skin And Health PLLC's NPI number?

The NPI number for Fall Creek Skin And Health PLLC is 1629247093. It was assigned to this organization in the NPPES registry on February 29, 2008.

Q: What is Fall Creek Skin And Health PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since February 29, 2008CLIA 13D1032996 · Microscopy

534 TREJO ST STE 400, REXBURG, ID 83440(208) 359-2263(208) 359-2042 Get Directions Write a Review

NPPES record last updated: June 26, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Fall Creek Skin And Health Pllc NPPES

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

FALL CREEK SKIN AND HEALTH PLLC (NPI 1629247093) is a healthcare organization registered as a medical in Rexburg, Idaho and active in the NPI registry since February 2008. The organization holds a CLIA Microscopy certificate valid through November 1, 2026 and lists Brett Gerald Bagley, Physician Assistant Certified, as its authorized official.

NPPES Registry Identity

NPI1629247093

Entity TypeOrganization

Primary Taxonomy363AM0700X

Legal Business NameFALL CREEK SKIN AND HEALTH PLLC

Location Address534 TREJO ST STE 400Rexburg, ID 83440

Mailing AddressPo Box 378Rexburg, ID 83440-0378 · (208) 359-2263 · Fax (208) 359-2042

Phone(208) 359-2263

Fax(208) 359-2042

Organization SubpartNo

Authorized OfficialBrett Gerald BagleyPhysician Assistant Certified · (208) 359-2263

Enumeration DateFebruary 29, 2008

Last NPPES UpdateJune 26, 2018

✔ NPI 1629247093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in ID · PA-215

534 TREJO ST STE 400, Rexburg, ID 83440

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Other Identifiers 1

Medicaid805069800ID

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 University of Utah Health Plans.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) 13D1032996

Fall Creek Skin & Health Clinic · Rexburg, ID

Active · expires Nov 1, 2026

CLIA Number13D1032996

Laboratory TypePhysician Office

Certificate Effective DateNovember 2, 2024

Certificate Expiration DateNovember 1, 2026

Laboratory DirectorBrett Bagley

Laboratory Phone(208) 359-2263

Laboratory LocationFall Creek Skin & Health Clinic534 Trejo St Ste 400, Rexburg, ID 83440

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.

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 Fall Creek Skin And Health PLLC's NPI number?

The NPI number for Fall Creek Skin And Health PLLC is 1629247093. It was assigned to this organization in the NPPES registry on February 29, 2008.

Where is Fall Creek Skin And Health PLLC located?

Fall Creek Skin And Health PLLC is located at 534 Trejo St Ste 400, Rexburg, ID 83440. The listed phone number is (208) 359-2263.

What is Fall Creek Skin And Health PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Does Fall Creek Skin And Health PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D1032996) is associated with this NPI, valid through November 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fall Creek Skin And Health PLLC accept?

Health plans from University of Utah Health Plans list Fall Creek Skin And Health PLLC 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 Fall Creek Skin And Health PLLC was last updated on June 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.