NPI age
17 years
Enumerated 2008-10-07
● Active Type 2 · Organization
Subpart
Southern Idaho Diabetes Education Program
Southern Idaho Diabetes Education Program 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
Pike
Sidep Coordinator
Last NPPES update
2008-10-07
Source: monthly bulk 2026-05
How this organization compares
Across 104 active clinic/center providers in Idaho.
NPI age
17 years
↑ 6 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-10Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
108 Nw Rail St
Shoshone, ID 83352
Mailing address
113 S Apple St
Shoshone, ID 833525287
Authorized official
Kathryn Evalena Pike, RN, CDE
Sidep Coordinator
📞 2089444747
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Single-site organization. Only one practice location on file.
Subpart of Shoshone Family Medical Center.
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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.