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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: August 02, 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
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Other Identifiers 1

Medicaid1184932584ID

Other Providers at the Same Location NPPES 6

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

VERNON T MULLINS MSN, APRN, FNP-BC
Nurse Practitioner (Family)
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850
ROBIN AMBER NETTLETON NP-C
Nurse Practitioner (Family)
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850
ST LUKES CLINIC-TREASURE VALLEY LLC
Family Medicine
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850
MR. DIRK KENNETH BASKETT PA-C
Physician Assistant (Medical)
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850
MR. JASON DALE OAKES FNP-C
Nurse Practitioner
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850
MELISSA MACLEAN
Nurse Practitioner (Family)
840 N 4TH E
MOUNTAIN HOME, ID 83647
Elmore County (208) 587-1850

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.

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 7 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.