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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

GEN STATE INTEGRATIVE MEDICINE
NPI 1790609477
Family Medicine in Meridian, ID

Active since August 06, 2026
1500 EAST HERITAGE PARK LANE, SUITE 150, SUITE 150, MERIDIAN, ID 83646(208) 202-7247(208) 202-7246 Get Directions Write a Review

NPPES record added: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gen State Integrative Medicine NPPES

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

GEN STATE INTEGRATIVE MEDICINE (NPI 1790609477) is a healthcare organization registered as a family medicine in Meridian, Idaho and active in the NPI registry since August 2026. The organization lists Jennifer Lyn Petrie, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1790609477
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGEN STATE INTEGRATIVE MEDICINE
Location Address1500 EAST HERITAGE PARK LANE, SUITE 150, SUITE 150Meridian, ID 83646
Mailing Address1500 East Heritage Park Lane, Suite 150, Suite 150Meridian, ID 83646 · (208) 202-7247 · Fax (208) 202-7246
Phone(208) 202-7247
Fax(208) 202-7246
Organization SubpartNo
Authorized OfficialJennifer Lyn PetrieOwner/president · (208) 365-7131
Enumeration DateAugust 6, 2026
✔ NPI 1790609477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1500 EAST HERITAGE PARK LANE, SUITE 150, Meridian, ID 83646
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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 Gen State Integrative Medicine's NPI number?

The NPI number for Gen State Integrative Medicine is 1790609477. It was assigned to this organization in the NPPES registry on August 6, 2026.

Where is Gen State Integrative Medicine located?

Gen State Integrative Medicine is located at 1500 East Heritage Park Lane, Suite 150 Suite 150, Meridian, ID 83646. The listed phone number is (208) 202-7247.

What is Gen State Integrative Medicine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Gen State Integrative Medicine was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.