SHOSHONE BANNOCK CLINIC
NPI 1801949763
Clinic/Center in Fort Hall, ID
About Shoshone Bannock Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHOSHONE BANNOCK CLINIC (NPI 1801949763) is a healthcare organization registered as a clinic/center in Fort Hall, Idaho and active in the NPI registry since January 2007. The organization lists Angela Mendez, Tribal Health Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 6
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shoshone Bannock Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Shoshone Bannock Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Shoshone Bannock Tribes, Inc's NPI number?
The NPI number for Shoshone Bannock Tribes, Inc is 1801949763. It was assigned to this organization in the NPPES registry on January 22, 2007. The provider is doing business as Shoshone Bannock Clinic.
Where is Shoshone Bannock Tribes, Inc located?
Shoshone Bannock Tribes, Inc is located at 717 Mission Road, Fort Hall, ID 83203. The listed phone number is (208) 238-2400.
What is Shoshone Bannock Tribes, Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Shoshone Bannock Tribes, Inc enrolled in Medicare?
Yes. Shoshone Bannock Tribes, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shoshone Bannock Tribes, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians reassign their Medicare billing to Shoshone Bannock Tribes, Inc, in Clinical Psychologist, Clinical Social Worker, Mental Health Counselor, Nurse Practitioner, Obstetrics/Gynecology and 1 other specialty. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Shoshone Bannock Tribes, Inc was last updated on January 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Shoshone Bannock Clinic · NPI 1801949763
Clinic/Center organization in Fort Hall, Idaho. Organization record, active in the CMS NPPES registry since January 22, 2007.
## Identity
- **NPI:** 1801949763 (Entity type: Organization)
- **Enumerated:** January 22, 2007
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Shoshone Bannock Tribes, Inc
- **Organization subpart:** Yes (part of Shoshone Bannock Tribes, Inc)
- **Authorized official:** Angela Mendez, TRIBAL HEALTH DIRECTOR
## Practice location
- **Address:** 717 MISSION ROAD, Fort Hall, ID 83203-0306
- **Phone:** (208) 238-2400 · **Fax:** (208) 238-5462
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Psychiatry (2), Clinical Psychologist (1); 1 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 25, 2010
- **Other identifiers:** Medicaid 002264100 (ID); Medicaid 806648600 (ID); Medicaid 003399100 (ID); and 3 more
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Source: [NPI Profile](https://npiprofile.com/npi/1801949763) · Data from the CMS NPPES public registry.