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NPI 1326080599
● Active Type 2 · Organization
Portneuf Medical Center
Skilled Nursing Facility · Pocatello, ID · NPI 1326080599
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Enumerated 2006 · 19 years on NPI
Portneuf Medical Center is 1 of 173 skilled nursing facility organizations in Idaho.
NPI age
19 years
Enumerated 2006-06-12
Primary specialty
Skilled Nursing Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wilker
Vp Finance & Cfo
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 173 active skilled nursing facility providers in Idaho.
NPI age
19 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
NPI lifetime · 2006 → 2026
2006-06 Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
651 Memorial Dr
Pocatello, ID 832014071
📞 2082391000 fax 2082392112
Mailing address
651 Memorial Dr
Pocatello, ID 832014071
📞 2082391000 fax 2082392112
Authorized official
Johnathan Wilker
Vp Finance & Cfo
📞 2082391020
Individual providers at this organization
15 individual providers on file at this primary practice address.
Craig Bosley , MD
Emergency Medicine
NPI 1992740120
Andrew Bradbury , MD
Emergency Medicine
NPI 1720016967
David Brizzee
Family Medicine
NPI 1225234420
Roberta Cole , CRT
Respiratory Therapist, Certified
NPI 1164692190
Leslie Conner , PA
Physician Assistant
NPI 1851302046
Marlene Corriere-Bransky , MD
Internal Medicine
NPI 1568500494
Jacob Delarosa , MD
Internal Medicine
NPI 1083759880
Randall Fowler , MD
Emergency Medicine
NPI 1154344059
Michael Francisco , MD
Internal Medicine
NPI 1871558239
William Hogan , MD
Family Medicine
NPI 1295974368
Carol Milder , NP
Internal Medicine
NPI 1972621340
Willis Parmley , MD
Emergency Medicine
NPI 1659316974
Steven Proctor , LCSW
Social Worker
NPI 1528228806
Kenneth Ryan , MD
Emergency Medicine
NPI 1003843343
James Shaw , MD
Emergency Medicine
NPI 1942238183
Specialties
Skilled Nursing Facility
Primary
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness...
ID license #H12 taxonomy 314000000X
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
15 individual providers on file at this primary address.
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How to verify this organization
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.
Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.