NPI age
19 years
Enumerated 2006-06-12
● Active Type 2 · Organization
Portneuf Medical Center
Portneuf Medical Center 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
Wilker
Vp Finance & Cfo
Last NPPES update
2020-08-22
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
2006-06Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
651 Memorial Dr
Pocatello, ID 832014071
Mailing address
651 Memorial Dr
Pocatello, ID 832014071
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
-
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...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Pocatello (ISU) Family Medicine
Practice context
Multi-provider organization. 15 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 145 Clinic/Center providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →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.