NPI age
19 years
Enumerated 2006-12-28
● Active Type 2 · Organization
Subpart
State Of Idaho Department Of Health And Welfare
State Of Idaho Department Of Health And Welfare is 1 of 145 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Shields
Patient Accounts Specialist
Last NPPES update
2016-07-15
Source: monthly bulk 2026-05
How this organization compares
Across 145 active clinic/center providers in Idaho.
NPI age
19 years
↑ 10 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-12Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
700 E. Alice, Box 400
Blackfoot, ID 832210400
Mailing address
700 E. Alice, Po Box 400
Blackfoot, ID 832210400
Authorized official
Lynn D Shields
Patient Accounts Specialist
📞 2087858462
Specialties
-
Clinic/Center PrimaryA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002823200 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
State Hospital South Medical Clinic
Practice context
Single-site organization. Only one practice location on file.
Subpart of State Hospital South.
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- 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.