POCATELLO CHILDREN & ADOLESCENT CLINIC NPI 1700898822

NPI Information

  • NPI: 1700898822
  • Provider Name: POCATELLO CHILDREN & ADOLESCENT CLINIC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • :
  • Address: 1151 HOSPITAL WAY BLDG F
    POCATELLO, ID
    ZIP 83201
  • Phone: (208) 232-1443

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NPI Details

POCATELLO CHILDREN & ADOLESCENT CLINIC is a pediatrics in Pocatello, ID. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. POCATELLO CHILDREN & ADOLESCENT CLINIC NPI is 1700898822. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

1151 HOSPITAL WAY BLDG F
POCATELLO, ID
ZIP 83201-091
Phone: (208) 232-1443
Fax: (208) 239-3434

The provider's authorized official is Jessica Perry .
The authorized official title is Administrator and has the following contact phone number (208) 236-9600.

The enumeration date for this NPI number is 8/13/2006 and was last updated on 3/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1002601400MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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