NPI age
7 years
Enumerated 2019-04-12
● Active Type 2 · Organization
Mountain States Diabetes Relief, Llc
Mountain States Diabetes Relief, Llc is 1 of 33 internal medicine organizations in Idaho.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Davenport
Partner
Last NPPES update
2019-04-12
Source: monthly bulk 2026-05
How this organization compares
Across 33 active internal medicine providers in Idaho.
NPI age
7 years
↓ 11 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2019 → 2026
2019-04Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
4573 E Majestic
Idaho Falls, ID 83406
Mailing address
4573 E Majestic
Idaho Falls, ID 83406
Authorized official
Katie Davenport
Partner
📞 2085202636
Specialties
-
Internal Medicine PrimaryAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary...
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.