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WALLACE BAKERS MID-LEVEL GROUP
NPI 1639370810
Physician Assistant - Medical in Idaho Falls, ID

Active since May 29, 2007
1880 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401(208) 524-6633(208) 524-9952 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wallace Bakers Mid-level Group NPPES

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

WALLACE BAKERS MID-LEVEL GROUP (NPI 1639370810) is a healthcare organization registered as a medical in Idaho Falls, Idaho and active in the NPI registry since May 2007. The organization lists Wallace Coleman Baker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1639370810
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameWALLACE BAKERS MID-LEVEL GROUP
Location Address1880 JOHN ADAMS PKWYIdaho Falls, ID 83401-4315
Mailing Address1880 John Adams PkwyIdaho Falls, ID 83401-4315 · (208) 524-6633 · Fax (208) 524-9952
Phone(208) 524-6633
Fax(208) 524-9952
Organization SubpartNo
Authorized OfficialWallace Coleman BakerCeo · (208) 524-6633
Enumeration DateMay 29, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1639370810 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 · M6919
1880 JOHN ADAMS PKWY, Idaho Falls, ID 83401
Open in Google Maps ↗

Other Identifiers 1

Medicaid8076593ID

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

Other Providers at the Same Location NPPES 8

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

WALLACE C BAKER M.D.
Family Medicine
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
WALLACE C BAKER
Family Medicine
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
WADE K CHRISTENSEN P.A.
Physician Assistant (Medical)
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
REBECCA JEAN NEWBY PA-C
Physician Assistant
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
JESSICA LYNNE CHRISTENSEN FNP
Nurse Practitioner
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
LAURA A TABOR P.A.
Physician Assistant (Medical)
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
JOSHUA E HANSEN PA-C
Physician Assistant (Medical)
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633
TELIETHA ANN HAMMON FNP-BC
Nurse Practitioner (Family)
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401
Bonneville County (208) 524-6633

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 Wallace Bakers Mid-Level Group's NPI number?

The NPI number for Wallace Bakers Mid-Level Group is 1639370810. It was assigned to this organization in the NPPES registry on May 29, 2007.

Where is Wallace Bakers Mid-Level Group located?

Wallace Bakers Mid-Level Group is located at 1880 John Adams Pkwy, Idaho Falls, ID 83401. The listed phone number is (208) 524-6633.

What is Wallace Bakers Mid-Level Group's specialty?

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

When was this NPI record last updated?

The NPPES record for Wallace Bakers Mid-Level Group 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 5 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.