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NORTH CANYON MOUNTAIN HOME CLINIC
NPI 1649759374
Clinic/Center in Mountain Home, ID

Active since August 13, 2018
840 N 4TH E, MOUNTAIN HOME, ID 83647(208) 934-8829(208) 934-4874 Get Directions Write a Review

NPPES record last updated: August 13, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About North Canyon Mountain Home Clinic NPPES

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

NORTH CANYON MOUNTAIN HOME CLINIC (NPI 1649759374) is a healthcare organization registered as a clinic/center in Mountain Home, Idaho and active in the NPI registry since August 2018. The organization lists Tim Powers, Ceo, as its authorized official.

NPPES Registry Identity

NPI1649759374
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameNORTH CANYON MOUNTAIN HOME CLINIC
Location Address840 N 4TH EMountain Home, ID 83647-2166
Mailing Address267 N Canyon DrGooding, ID 83330-5500 · (208) 934-4433
Phone(208) 934-8829
Fax(208) 934-4874
Organization SubpartNo
Authorized OfficialTim PowersCeo · (208) 934-8765
Enumeration DateAugust 13, 2018
✔ NPI 1649759374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
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).
840 N 4TH E, Mountain Home, ID 83647
Open in Google Maps ↗

Other Identifiers 1

Medicaid1184932584ID

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

North Canyon Mountain Home Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

180

Medicare enrollment records show 180 clinicians reassign Medicare billing to North Canyon Mountain Home Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 32

Diagnostic Radiology73
Certified Registered Nurse Anesthetist (CRNA)23
Nurse Practitioner13
Emergency Medicine12
Family Practice10
Pain Management5
Cardiovascular Disease (Cardiology)3
Interventional Cardiology3
24 other specialties38

Nearest to this location (20)

See all 180
Andrew Ewell, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1467749887
338 E BANNOCK ST
Boise, ID 83712
(208) 336-0895
✔ Accepts Medicare41 mi
Marcos Daccarett, MD
Cardiac Electrophysiology
NPI 1023144300
300 E JEFFERSON ST STE 101
Boise, ID 83712
(208) 336-4141
✔ PECOS✔ Accepts Medicare41 mi
Robert Duerr, MD
Interventional Cardiology
NPI 1588611263
300 E JEFFERSON ST SUITE 101
Boise, ID 83712
(208) 322-1680
✔ PECOS✔ Accepts Medicare41 mi
Samual Bass, MD
Cardiovascular Disease (Cardiology)
NPI 1841234747
300 E JEFFERSON STE 101
Boise, ID 83712
(208) 336-4141
✔ PECOS✔ Accepts Medicare41 mi
Shane Ball, M.D.
Diagnostic Radiology
NPI 1679500557
190 E BANNOCK ST
Boise, ID 83712
(208) 381-2094
✔ PECOS✔ Accepts Medicare41 mi
Andrew Peterson, M.D.
Interventional Radiology
NPI 1083842033
190 E BANNOCK ST
Boise, ID 83712
(208) 381-2094
✔ PECOS✔ Accepts Medicare41 mi
Joshua Berlat, MD
Emergency Medicine
NPI 1396139325
190 E BANNOCK ST
Boise, ID 83712
(208) 381-2222
✔ PECOS✔ Accepts Medicare41 mi
Carla Dirmann, NP
Nurse Practitioner
NPI 1851624282
1673 W SHORELINE DR STE 100
Boise, ID 83702
(208) 593-3054
✔ PECOS✔ Accepts Medicare42 mi
Megan Mccarren, MD
Addiction Medicine
NPI 1841490950
5966 W CURTISIAN AVE
Boise, ID 83704
(208) 302-5460
✔ PECOS✔ Accepts Medicare43 mi
Cooper Field, MD
Family Practice
NPI 1679036149
267 N CANYON DR
Gooding, ID 83330
(208) 934-4446
✔ PECOS✔ Accepts Medicare49 mi
Kyle Grooms, M.D.
Hand Surgery
NPI 1548680622
267 N CANYON DR
Gooding, ID 83330
(208) 329-0345
✔ PECOS✔ Accepts Medicare49 mi
Tyler Mcomber, OTR/L
Occupational Therapist in Private Practice
NPI 1346026747
267 N CANYON DR
Gooding, ID 83330
(208) 934-9693
✔ Accepts Medicare49 mi
Jeremiah Yates, DPT
Physical Therapist in Private Practice
NPI 1083815757
241 MAIN ST
Gooding, ID 83330
(208) 934-4433
✔ Accepts Medicare52 mi
Toby Anderton, M.D.
Orthopedic Surgery
NPI 1225359474
2167 VILLAGE PARK AVE SUITE 200
Twin Falls, ID 83301
(208) 735-3728
✔ PECOS✔ Accepts Medicare71 mi
Cory Bates, M.D.
Urology
NPI 1629256573
775 POLE LINE RD W SUITE 301
Twin Falls, ID 83301
(208) 814-8700
✔ PECOS✔ Accepts Medicare72 mi
Brian Fortuin, M.D.
Internal Medicine
NPI 1740221191
775 POLE LINE RD W SUITE 302
Twin Falls, ID 83301
(208) 814-8600
✔ PECOS✔ Accepts Medicare72 mi
Margaret Wright, M.S., CF-SLP
Qualified Speech Language Pathologist
NPI 1205312956
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1000
✔ Accepts Medicare72 mi
Richard Hammond, M.D.
Neurology
NPI 1558306589
738 N COLLEGE RD SUITE C
Twin Falls, ID 83301
(208) 814-7100
✔ PECOS✔ Accepts Medicare73 mi
Jennifer Cowan, M.S. IN COUNSELING
Mental Health Counselor
NPI 1144803875
209 WASHINGTON ST N
Twin Falls, ID 83301
(208) 654-0134
✔ PECOS73 mi
Camille Magalogo, LCSW, RPT-S
Clinical Social Worker
NPI 1316122773
647 FILER AVE
Twin Falls, ID 83301
(208) 737-9999
✔ PECOS✔ Accepts Medicare74 mi
See all 180 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 North Canyon Mountain Home Clinic's NPI number?

The NPI number for North Canyon Mountain Home Clinic is 1649759374. It was assigned to this organization in the NPPES registry on August 13, 2018.

Where is North Canyon Mountain Home Clinic located?

North Canyon Mountain Home Clinic is located at 840 N 4th E, Mountain Home, ID 83647. The listed phone number is (208) 934-8829.

What is North Canyon Mountain Home Clinic's specialty?

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

Is North Canyon Mountain Home Clinic enrolled in Medicare?

Yes. North Canyon Mountain Home Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through North Canyon Mountain Home Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 180 clinicians in 32 Medicare specialties reassign their Medicare billing to North Canyon Mountain Home Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (73), Certified Registered Nurse Anesthetist (CRNA) (23) and Nurse Practitioner (13). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for North Canyon Mountain Home Clinic was last updated on August 13, 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.