NPI age
6 years
Enumerated 2020-01-31
● Active Type 2 · Organization
Idaho Modern Medicine - Pllc
Idaho Modern Medicine - Pllc is 1 of 1691 family medicine organizations in Idaho.
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Anderson
Physician / Owner
Last NPPES update
2024-02-05
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
6 years
↓ 11 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2020 → 2026
2020-01Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
1000 Pocatello Creek Rd Ste E10
Pocatello, ID 832012953
Mailing address
1000 Pocatello Creek Rd Ste E10
Pocatello, ID 832012953
Authorized official
Michael A Anderson, DO
Physician / Owner
📞 2086484789
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Michael Anderson, DO Family Medicine NPI 1124406186
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Practice context
Multi-provider organization. 1 individual provider 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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.