NPI age
19 years
Enumerated 2007-05-14
● Active Type 2 · Organization
South Park, Inc.
South Park, Inc. is 1 of 303 case management organizations in Idaho.
Primary specialty
Case Management
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McCoy
Executive Director
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 303 active case management providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
415 S Arthur Ave
Pocatello, ID 832043303
Mailing address
415 S Arthur Ave
Pocatello, ID 832043303
Authorized official
Russell C McCoy, M.A.ED
Executive Director
📞 2082336833
Specialties
-
Case Management PrimaryAn organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Developmental Options
Practice context
Single-site organization. Only one practice location on file.
Provyx · Custom healthcare lists
Need all 303 Case Management providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.