NPI age
18 years
Enumerated 2007-06-25
● Active Type 2 · Organization
Eye Clinic Of Idaho Falls,pa
Eye Clinic Of Idaho Falls,pa is 1 of 122 ophthalmology organizations in Idaho.
Primary specialty
Ophthalmology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Anderson
Medical Director
Last NPPES update
2011-09-15
Source: monthly bulk 2026-05
How this organization compares
Across 122 active ophthalmology providers in Idaho.
NPI age
18 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-06Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
530 S Holmes Ave
Idaho Falls, ID 834014751
Mailing address
Po Box 2410
Idaho Falls, ID 834032410
Authorized official
David R Anderson, M.D.
Medical Director
📞 2085293937
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Shayna Mickelsen Nurse Practitioner NPI 1639024888
- Benjamin Rae Nurse Practitioner NPI 1770051229
- Jeanette Slater, FNP-C Family Medicine NPI 1265293021
- Cathleen Smith, LMT Massage Therapist NPI 1366045817
Specialties
-
Ophthalmology PrimaryAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 00240930 | |
| 01 (ID) | 1205974136 | INDIVIDUAL NPI |
| 05 (ID) | 003572200 |
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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