NPI age
19 years
Enumerated 2007-01-18
● Active Type 2 · Organization
Sleep Disorder Center Of Eastern Idaho, Inc.
Sleep Disorder Center Of Eastern Idaho, Inc. is 1 of 11 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jackson
Owner
Last NPPES update
2008-12-18
Source: monthly bulk 2026-05
How this organization compares
Across 11 active clinic/center providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2001 S Woodruff, Ste 11
Idaho Falls, ID 83404
Mailing address
2001 S Woodruff, Ste 11
Idaho Falls, ID 83404
Authorized official
Sandra M Jackson, POLYSOMNOGRAPHIST
Owner
📞 2085248044
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Judy Jones, MD Family Medicine NPI 1295707099
- Roger Tall, MD Urology NPI 1972604494
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 8A646 | BLUE CROSS |
| 01 | 000010001762 | BLUE SHIELD |
| 05 (ID) | 805240900 |
Practice context
Multi-provider organization. 2 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.