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SOUTHEAST IDAHO GASTROENTEROLOGY, PLLC
NPI 1780867457
Physician Assistant - Medical in Pocatello, ID

Active since December 17, 2007
1151 HOSPITAL WAY STE A, POCATELLO, ID 83201(208) 232-6616(208) 232-6618 Get Directions Write a Review

NPPES record last updated: December 17, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southeast Idaho Gastroenterology, Pllc NPPES

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

SOUTHEAST IDAHO GASTROENTEROLOGY, PLLC (NPI 1780867457) is a healthcare organization registered as a medical in Pocatello, Idaho and active in the NPI registry since December 2007. The organization lists Debbie J Ferrel, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1780867457
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameSOUTHEAST IDAHO GASTROENTEROLOGY, PLLC
Location Address1151 HOSPITAL WAY STE APocatello, ID 83201-5091
Mailing Address1151 Hospital Way Ste APocatello, ID 83201-5091 · (208) 232-6616 · Fax (208) 232-6618
Phone(208) 232-6616
Fax(208) 232-6618
Organization SubpartNo
Authorized OfficialDebbie J FerrelPractice Manager · (208) 232-6616
Enumeration DateDecember 17, 2007
✔ NPI 1780867457 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 · PA-629
1151 HOSPITAL WAY STE A, Pocatello, ID 83201
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Other Identifiers 1

Medicaid806196200ID

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

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 Southeast Idaho Gastroenterology, PLLC's NPI number?

The NPI number for Southeast Idaho Gastroenterology, PLLC is 1780867457. It was assigned to this organization in the NPPES registry on December 17, 2007.

Where is Southeast Idaho Gastroenterology, PLLC located?

Southeast Idaho Gastroenterology, PLLC is located at 1151 Hospital Way Ste A, Pocatello, ID 83201. The listed phone number is (208) 232-6616.

What is Southeast Idaho Gastroenterology, PLLC'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 Southeast Idaho Gastroenterology, PLLC was last updated on December 17, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.