NPI age
7 years
Enumerated 2018-08-13
● Active Type 2 · Organization
North Canyon Mountain Home Clinic
North Canyon Mountain Home Clinic 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
Powers
Ceo
Last NPPES update
2018-08-13
Source: monthly bulk 2026-05
How this organization compares
Across 145 active clinic/center providers in Idaho.
NPI age
7 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2018 → 2026
2018-08Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
840 N 4th E
Mountain Home, ID 836472166
Mailing address
267 N Canyon Dr
Gooding, ID 833305500
Authorized official
Tim Powers
Ceo
📞 2089348765
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Dirk Baskett, PA-C Physician Assistant NPI 1841920220
- Melissa MacLean Nurse Practitioner NPI 1922707686
- Vernon Mullins, MSN, APRN, FNP-BC Nurse Practitioner NPI 1255168449
- Robin Nettleton, NP-C Nurse Practitioner NPI 1336784081
- Jason Oakes, FNP-C Nurse Practitioner NPI 1902751423
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) | 1184932584 |
Practice context
Multi-provider organization. 5 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.