NPI age
17 years
Enumerated 2008-06-10
● Active Type 2 · Organization
Lee Self MD PA
Lee Self MD PA is 1 of 305 specialist organizations in Idaho.
Primary specialty
Specialist
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Self
President
Last NPPES update
2023-03-24
Source: monthly bulk 2026-05
How this organization compares
Across 305 active specialist providers in Idaho.
NPI age
17 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 11% of peers with subspecialties
NPI lifetime · 2008 → 2026
2008-06Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
2020 S Johns Ave Ste B
Emmett, ID 836179410
Mailing address
23000 Sweet Ola Hwy
Ola, ID 836575027
Authorized official
Lee Self, MD
President
📞 2084257507
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Jonathan Barrus, D.O. Family Medicine NPI 1346654589
- Lee Self, MD Obstetrics & Gynecology NPI 1639121361
- Andrea Walsh, DNP, FNP-C Nurse Practitioner NPI 1376992503
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
-
Clinic/CenterDefinition to come...
Practice context
Multi-provider organization. 3 individual providers 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.