P Praxis·MD
● Active Type 2 · Organization

Idaho Dept Of Health & Welfare Reg 7 Amh Bf

Clinic/Center·Blackfoot, ID· NPI 1114058179 · Enumerated 2007 · 19 years on NPI
Idaho Dept Of Health & Welfare Reg 7 Amh Bf is 1 of 326 clinic/center organizations in Idaho.
NPI age
19 years
Enumerated 2007-03-08
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Rodriquez
Program Manager
Last NPPES update
2010-08-10
Source: monthly bulk 2026-05

How this organization compares

Across 326 active clinic/center providers in Idaho.

NPI age
19 years
↑ 14 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2007 → 2026

2007-03Enumerated in NPPES
2007 2026

Where they practice

Primary practice location
720 E Alice
Blackfoot, ID 832210129
📞 2087855871fax 2087855877
Mailing address
720 E Alice Po Box 129
Blackfoot, ID 832210129
📞 2087855871fax 2087855877

Authorized official

Randy Rodriquez, LCSW
Program Manager
📞 2085285700

Specialties

  • Clinic/Center Primary
    Definition to come...
    taxonomy 261QM0801X

Identifiers

TypeValueNotes
05 (ID) 8073683
01 (ID) 000010019479 BLUE SHIELD
01 (ID) HW181 BLUE CROSS

Practice context

Single-site organization. Only one practice location on file.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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