IDAHO STATE SPORTS MEDICINE – NPI #1801292115
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.

IDAHO STATE SPORTS MEDICINE is a provider located in POCATELLO, ID. NPPES has assigned the NPI number 1801292115 to IDAHO STATE SPORTS MEDICINE on November 13, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “IDAHO STATE SPORTS MEDICINE” is a dba name, the actual legal business name for this organization is IDAHO STATE UNIVERSITY. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

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 IDAHO STATE SPORTS MEDICINE below.

NPI Profile for
IDAHO STATE UNIVERSITY

NPI Number
1801292115
Enumeration Date

(more than 11 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
IDAHO STATE UNIVERSITY
Doing Business As (dba): IDAHO STATE SPORTS MEDICINE
Primary location
921 S 8TH AVE STOP 8173
SPORTS AND ORTHOPAEDIC CENTER
POCATELLO, ID 83209-8173
Phone: (208) 282-3408 Fax:
Mailing address
5050 SPRING VALLEY RD
DALLAS, TX 75244-3995
Phone: (800) 555-9073 Fax: (972) 367-3452
Organization Subpart
No
Authorized Official
JODI WOTOWEY
HEAD ATHLETIC TRAINER
Phone: (208) 282-3408
Updated
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.

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.