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IDAHO STATE SPORTS MEDICINE
NPI 1801292115
Family Medicine in Pocatello, ID

Active since November 13, 2014
921 S 8TH AVE STOP 8173, SPORTS AND ORTHOPAEDIC CENTER, POCATELLO, ID 83209(208) 282-3408 Get Directions Write a Review

NPPES record last updated: November 13, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Idaho State Sports Medicine NPPES

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

IDAHO STATE SPORTS MEDICINE (NPI 1801292115) is a healthcare organization registered as a family medicine in Pocatello, Idaho and active in the NPI registry since November 2014. The organization lists Jodi Wotowey, Head Athletic Trainer, as its authorized official.

NPPES Registry Identity

NPI1801292115
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameIDAHO STATE UNIVERSITY
Location Address921 S 8TH AVE STOP 8173, SPORTS AND ORTHOPAEDIC CENTERPocatello, ID 83209-8173
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995 · (800) 555-9073 · Fax (972) 367-3452
Phone(208) 282-3408
Organization SubpartNo
Authorized OfficialJodi WotoweyHead Athletic Trainer · (208) 282-3408
Enumeration DateNovember 13, 2014
✔ NPI 1801292115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X
921 S 8TH AVE STOP 8173, Pocatello, ID 83209
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Other Names 1

Doing Business AsIdaho State Sports Medicine

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

MR. BRANDON CHARLES PAYNE ATC
Specialist/Technologist (Athletic Trainer)
921 S 8TH AVE STOP 8173
POCATELLO, ID 83209
Bannock County (989) 621-2374
ELIZABETH REINSTEIN MS, ATC/L, CSCS
Specialist/Technologist (Athletic Trainer)
921 S 8TH AVE STOP 8173
POCATELLO, ID 83209
Bannock County (208) 282-3408

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 Idaho State University's NPI number?

The NPI number for Idaho State University is 1801292115. It was assigned to this organization in the NPPES registry on November 13, 2014. The provider is doing business as Idaho State Sports Medicine.

Where is Idaho State University located?

Idaho State University is located at 921 S 8th Ave Stop 8173 Sports And Orthopaedic Center, Pocatello, ID 83209. The listed phone number is (208) 282-3408.

What is Idaho State University'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 Idaho State University was last updated on November 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.