P Praxis·MD
● Active Type 2 · Organization

Portneuf Nephrology Center

Clinic/Center·Pocatello, ID· NPI 1164413753 · Enumerated 2005 · 20 years on NPI
Portneuf Nephrology Center is 1 of 46 clinic/center organizations in Idaho.
NPI age
20 years
Enumerated 2005-11-02
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jacobs
Accounts Receivable Manager
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05

How this organization compares

Across 46 active clinic/center providers in Idaho.

NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2005 → 2026

2005-11Enumerated in NPPES
2005 2026

Where they practice

Primary practice location
2001 Bench Rd
Pocatello, ID 832012033
📞 2086371090fax 2086371097
Mailing address
5610 Gage St
Boise, ID 837061332
📞 2083673076fax 2083676909

Authorized official

Jan M Jacobs
Accounts Receivable Manager
📞 2083673076

Specialties

  • Clinic/Center Primary
    Definition to come...
    ID license #BM7847203 taxonomy 261QE0700X

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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