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SHOSHONE BANNOCK CLINIC PODIATRY GROUP
NPI 1952518946
Podiatrist in Fort Hall, ID

Active since May 17, 2007
717 MISSION ROAD, FORT HALL, ID 83203(208) 238-5421(208) 238-5462 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shoshone Bannock Clinic Podiatry Group NPPES

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

SHOSHONE BANNOCK CLINIC PODIATRY GROUP (NPI 1952518946) is a healthcare organization registered as a podiatrist in Fort Hall, Idaho and active in the NPI registry since May 2007. The organization lists Angela Mendez, Tribal Health Director, as its authorized official.

NPPES Registry Identity

NPI1952518946
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameSHOSHONE BANNOCK TRIBES
Location Address717 MISSION ROADFort Hall, ID 83203
Mailing AddressPo Box 306, Pima DriveFort Hall, ID 83203-0306 · (208) 478-3994 · Fax (208) 478-3943
Phone(208) 238-5421
Fax(208) 238-5462
Organization SubpartNo
Authorized OfficialAngela MendezTribal Health Director · (208) 478-3994
Enumeration DateMay 17, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1952518946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

717 MISSION ROAD, Fort Hall, ID 83203
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Other Names 1

Doing Business AsShoshone Bannock Clinic Podiatry Group

Other Identifiers 1

Medicaid8066486ID

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

Other Providers at the Same Location NPPES 7

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

SHOSHONE BANNOCK TRIBES, INC
Clinic/Center
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 238-2400
MR. THAYNE ANDERSEN LCSW
Social Worker (Clinical)
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 237-5631
MRS. ASHLEY L BALLENSKY RN
Registered Nurse (Ambulatory Care)
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 238-5423
MATTHEW J WADSWORTH LCSW
Social Worker (Clinical)
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 237-5631
DANIEL JEROME HALL LCSW
Social Worker (Clinical)
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 237-5631
NOT-TSOO GAH-NEE INDIAN HEALTH CENTER
Clinic/Center (Multi-Specialty)
717 MISSION ROAD
FORT HALL, ID 83203
Bingham County (208) 238-5400
MISS CHANTELLE E BOWMAN PA-C
Physician Assistant
717 MISSION ROAD, COMMUNITY HEALTH NURSING PROGRAM
FORT HALL, ID 83203
Bingham County (208) 238-5435

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's NPI number?

The NPI number for Shoshone Bannock Tribes is 1952518946. It was assigned to this organization in the NPPES registry on May 17, 2007.

Where is Shoshone Bannock Tribes located?

Shoshone Bannock Tribes is located at 717 Mission Road, Fort Hall, ID 83203. The listed phone number is (208) 238-5421.

What is Shoshone Bannock Tribes's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for Shoshone Bannock Tribes was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.