SPECIALIZED FAMILY MEDICINE – NPI #1124197702
Family Medicine

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.

SPECIALIZED FAMILY MEDICINE is a provider located in POCATELLO, ID. NPPES has assigned the NPI number 1124197702 to SPECIALIZED FAMILY MEDICINE on November 07, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SPECIALIZED FAMILY MEDICINE below.

NPI Profile for
SPECIALIZED FAMILY MEDICINE

NPI Number
1124197702
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SPECIALIZED FAMILY MEDICINE
Primary location
151 N 4TH AVE
SUITE B
POCATELLO, ID 83201-6300
Phone: (208) 369-7147 Fax: (208) 416-6522
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JORDAN BAILEY
PHYSICIAN OWNER
Phone: (208) 269-7147
Updated
Identifiers

Identifiers for SPECIALIZED FAMILY MEDICINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSSID8F991
MEDICAIDID806364600
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
ID

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.