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STATE STREET IMMEDIATE MEDICAL CARE
NPI 1992895866
Family Medicine in Boise, ID

Active since October 13, 2006
4902 W STATE ST, BOISE, ID 83703(208) 853-3100(208) 853-3120 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About State Street Immediate Medical Care NPPES

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

STATE STREET IMMEDIATE MEDICAL CARE (NPI 1992895866) is a healthcare organization registered as a family medicine in Boise, Idaho and active in the NPI registry since October 2006. The organization lists Corinne K Chastain, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1992895866
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePHYSICIANS CLINIC PLLC
Location Address4902 W STATE STBoise, ID 83703-3326
Mailing Address4902 W State StBoise, ID 83703-3326 · (208) 853-3100 · Fax (208) 853-3120
Phone(208) 853-3100
Fax(208) 853-3120
Organization SubpartNo
Authorized OfficialCorinne K ChastainOffice Manager · (208) 375-0500
Enumeration DateOctober 13, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1992895866 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.
4902 W STATE ST, Boise, ID 83703
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Other Names 1

Other NameState Street Immediate Medical Care

Other Identifiers 1

Other8M400ID · Blue Cross

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 4

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

MR. ERIK K HANSON PA-C
Physician Assistant
4902 W STATE ST
BOISE, ID 83703
Ada County (208) 302-3900
CARL RYAN ANDRUS P.A.
Physician Assistant
4902 W STATE ST
BOISE, ID 83703
Ada County (208) 853-3100
CORNERSTONE ORTHOPAEDIC TRAUMA ASSOCIATES
Orthopaedic Surgery
4902 W STATE ST
BOISE, ID 83703
Ada County (208) 579-7200
BRYAN DAVID HARR PA-C
Physician Assistant
4902 W STATE ST
BOISE, ID 83703
Ada County (208) 579-7200

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 Physicians Clinic PLLC's NPI number?

The NPI number for Physicians Clinic PLLC is 1992895866. It was assigned to this organization in the NPPES registry on October 13, 2006. The provider is also known as State Street Immediate Medical Care.

Where is Physicians Clinic PLLC located?

Physicians Clinic PLLC is located at 4902 W State St, Boise, ID 83703. The listed phone number is (208) 853-3100.

What is Physicians Clinic PLLC'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 Physicians Clinic PLLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.