NPI age
18 years
Enumerated 2007-10-09
● Active Type 2 · Organization
Subpart
Bmh Inc
Bmh Inc is 1 of 61 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Erickson
Ceo
Last NPPES update
2021-02-11
Source: monthly bulk 2026-05
How this organization compares
Across 61 active clinic/center providers in Idaho.
NPI age
18 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 29% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-10Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
275 W Locust St
Shelley, ID 832741230
Mailing address
275 W Locust St
Shelley, ID 832741230
Authorized official
Jacob Erickson
Ceo
📞 2087853801
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Kenneth Blackner, M.D. General Practice NPI 1043339641
Specialties
-
Clinic/Center PrimaryDefinition to come...
-
Clinic/CenterDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 8N304 | BLUE CROSS OF IDAHO |
| 05 (ID) | 807947000 | |
| 01 (ID) | 000010137702 | BLUE SHIELD OF IDAHO |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Physicians and Surgeons of Shelley
-
Physicians and Surgeons of Shelley
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Bmh Inc..
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