1. Home
  2. Directory
  3. Idaho
  4. Fruitland
  5. Clinic Center
  6. NPI Profile

SNAKE RIVER PEDIATRICS, PC
NPI 1720489396
Clinic/Center - Rural Health in Fruitland, ID

Active since September 14, 2014
1100 NW 12TH ST, FRUITLAND, ID 83619(208) 452-6556(541) 216-6557 Get Directions Write a Review

NPPES record last updated: August 16, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2023, Aug 13, 2018, Jul 19, 2018 (3 updates tracked since 2018).

About Snake River Pediatrics, Pc NPPES

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

SNAKE RIVER PEDIATRICS, PC (NPI 1720489396) is a healthcare organization registered as a rural health in Fruitland, Idaho and active in the NPI registry since September 2014. The organization lists Matthew Joseph Berria, President, as its authorized official.

NPPES Registry Identity

NPI1720489396
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSNAKE RIVER PEDIATRICS, PC
Location Address1100 NW 12TH STFruitland, ID 83619-5040
Mailing Address1100 Nw 12th StFruitland, ID 83619-5040 · (208) 452-6556 · Fax (541) 216-6557
Phone(208) 452-6556
Fax(541) 216-6557
Organization SubpartNo
Authorized OfficialMatthew Joseph BerriaPresident · (208) 740-4518
Enumeration DateSeptember 14, 2014
Last NPPES UpdateAugust 16, 20233 updates tracked since enumeration
NPPES CertifiedAugust 16, 2023
✔ NPI 1720489396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License PA00913 (OR)
1100 NW 12TH ST, Fruitland, ID 83619
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 15

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

BRADI FRITTS LCSW
Social Worker (Clinical)
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 739-6248
PAGE LYN ERNTSON LCSW
Social Worker
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
ABBY LYNN DAVIS
Pediatrics
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
KAYLA A NAGY PA-C
Physician Assistant (Medical)
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
CHELSIE M LEWIS FNP
Nurse Practitioner (Family)
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
ELIZABETH FRASIER LMSW
Social Worker
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
MICHELLE F DEVOE D.O.
Pediatrics (Adolescent Medicine)
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556
SNAKE RIVER PEDIATRICS, PC
Clinic/Center (Rural Health)
1100 NW 12TH ST
FRUITLAND, ID 83619
Payette County (208) 452-6556

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 Snake River Pediatrics, PC's NPI number?

The NPI number for Snake River Pediatrics, PC is 1720489396. It was assigned to this organization in the NPPES registry on September 14, 2014.

Where is Snake River Pediatrics, PC located?

Snake River Pediatrics, PC is located at 1100 NW 12th St, Fruitland, ID 83619. The listed phone number is (208) 452-6556.

What is Snake River Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Snake River Pediatrics, PC accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Snake River Pediatrics, PC 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 Snake River Pediatrics, PC was last updated on August 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.