NPI age
16 years
Enumerated 2009-11-17
● Active Type 2 · Organization
Subpart
Phs MD #1, Llc
Phs MD #1, Llc is 1 of 104 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Abreu
Cfo
Last NPPES update
2010-03-02
Source: monthly bulk 2026-05
How this organization compares
Across 104 active clinic/center providers in Idaho.
NPI age
16 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-11Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
651 Memorial Dr
Pocatello, ID 832014071
Mailing address
Po Box 4168
Pocatello, ID 832054168
Authorized official
John Abreu
Cfo
📞 2082392110
Individual providers at this organization
15 individual providers on file at this primary practice address.
- Craig Bosley, MD Emergency Medicine NPI 1992740120
- Andrew Bradbury, MD Emergency Medicine NPI 1720016967
- David Brizzee Family Medicine NPI 1225234420
- Roberta Cole, CRT Respiratory Therapist, Certified NPI 1164692190
- Leslie Conner, PA Physician Assistant NPI 1851302046
- Marlene Corriere-Bransky, MD Internal Medicine NPI 1568500494
- Jacob Delarosa, MD Internal Medicine NPI 1083759880
- Randall Fowler, MD Emergency Medicine NPI 1154344059
- Michael Francisco, MD Internal Medicine NPI 1871558239
- William Hogan, MD Family Medicine NPI 1295974368
- Carol Milder, NP Internal Medicine NPI 1972621340
- Willis Parmley, MD Emergency Medicine NPI 1659316974
- Steven Proctor, LCSW Social Worker NPI 1528228806
- Kenneth Ryan, MD Emergency Medicine NPI 1003843343
- James Shaw, MD Emergency Medicine NPI 1942238183
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
PORTNEUF MEDICAL PRACTICES
Practice context
Multi-provider organization. 15 individual providers on file at this primary address.
Subpart of Pocatello Health Services, Llc.
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- 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.