FALL CREEK SKIN AND HEALTH PLLC
NPI 1629247093
Physician Assistant - Medical in Rexburg, ID
NPI Status: Active since February 29, 2008
Contact Information
534 TREJO ST STE 400
REXBURG, ID
ZIP 83440
Phone: (208) 359-2263
Fax: (208) 359-2042
- Organization
- Physician Assistant
- Medical
- Accepts Insurance
- CLIA Number: 13D1032996
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-01-2026
About FALL CREEK SKIN AND HEALTH PLLC
This page provides the complete NPI Profile along with additional information for Fall Creek Skin And Health Pllc, a primary care provider established in Rexburg, Idaho operating as a Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1629247093 assigned on February 2008. The practitioner's primary taxonomy code is 363AM0700X with license number PA-215 (ID). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Brett Gerald Bagley P.a.-c. (Physician Assistant Certified)
- NPI
- 1629247093
- Provider Name
- FALL CREEK SKIN AND HEALTH PLLC
- Entity Type
- Organization
- Location Address
- 534 TREJO ST STE 400 REXBURG, ID 83440
- Location Phone
- (208) 359-2263
- Location Fax
- (208) 359-2042
- Mailing Address
- PO BOX 378 REXBURG, ID 83440
- Mailing Phone
- (208) 359-2263
- Mailing Fax
- (208) 359-2042
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-29-2008
- Last Update Date
- 06-26-2018
- Code Navigator
A primary care provider (PCP) like Fall Creek Skin And Health Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA-215
- License State
- ID
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 805069800 | MEDICAID (05) | ID |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D1032996
- Facility Type
- Physician Office
- Certificate Effective Date
- November 02, 2024
- Certificate Expiration Date
- November 01, 2026
- Laboratory Director
- BRETT BAGLEY
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Fall Creek Skin And Health Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1629247093, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629247093, enumerated as an "organization" on February 29, 2008.
The provider is located at 534 TREJO ST STE 400 REXBURG, ID 83440 and the phone number is (208) 359-2263.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
The provider might be accepting Accepts: University of Utah Health Plans, Medicare and. Please consult your insurance carrier or call the provider to verify.
