NPI age
19 years
Enumerated 2006-06-01
● Active Type 2 · Organization
Blue Lakes Gastroenterology, Pllc
Blue Lakes Gastroenterology, Pllc is 1 of 111 internal medicine organizations in Idaho.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ward
Physician
Last NPPES update
2013-03-09
Source: monthly bulk 2026-05
How this organization compares
Across 111 active internal medicine providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
775 Pole Line Rd W, Suite 203
Twin Falls, ID 833015814
Mailing address
775 Pole Line Rd W, Suite 203
Twin Falls, ID 833015814
Authorized official
Robert Ward, M.D.
Physician
📞 2088148300
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Marci Ahlquist Nurse Practitioner NPI 1376084673
- Julie Akins, FNP Nurse Practitioner NPI 1285811505
- Kovic Bailey, DO Family Medicine NPI 1194467688
- John Baker, M.D. Internal Medicine NPI 1124061262
- Gregory Ball, DO Internal Medicine NPI 1407985278
- Gretchen Basen, PA-C Physician Assistant NPI 1861549396
- Cory Bates, M.D. Urology NPI 1629256573
- Ronald Blair, D.O. Surgery NPI 1114947389
- Patrick Desmond, M.D. Internal Medicine NPI 1821038282
- Dennis Enomoto, MD Internal Medicine NPI 1649226127
- Daryl Ficklin, DO Internal Medicine NPI 1346213303
- Brian Fortuin, M.D. Internal Medicine NPI 1740221191
- Kristi Fregia Rucks, P.T. Physical Therapist NPI 1871659748
- Jason Greenhalgh, M.D. Urology NPI 1952478703
- Kenneth Harris, MD Family Medicine NPI 1447295480
- Reed Harris, D.O. Internal Medicine NPI 1780616888
- Jeffrey Himes, OTR/L Occupational Therapist NPI 1548449358
- Joseph Hymas, MD Internal Medicine NPI 1942490578
- David Johnson, M.D. Surgery NPI 1922035104
- Brandy Jones, ADULT-GERONTOLOGY NP Nurse Practitioner NPI 1750900320
Specialties
-
Internal Medicine PrimaryAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806237600 | |
| 01 (ID) | CJ6218 | RR MEDICARE |
Practice context
Multi-provider organization. 20 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 →
- 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.