NPI age
19 years
Enumerated 2006-07-04
● Active Type 2 · Organization
Mountain State Family Medicine, Pc
Mountain State Family Medicine, Pc is 1 of 104 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Leblanc
President
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 104 active clinic/center providers in Idaho.
NPI age
19 years
↑ 8 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
610 Nw 2nd St
Grangeville, ID 835301244
Mailing address
610 Nw 2nd St
Grangeville, ID 835301244
Authorized official
Leanne L Leblanc, M.D.
President
📞 2089835120
Individual providers at this organization
1 individual provider on file at this primary practice address.
- William Imus, FNP Nurse Practitioner NPI 1902836802
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010017999 | REGENCE BLUE SHIELD |
| 01 (ID) | 8M434 | BLUE CROSS OF IDAHO |
Practice context
Multi-provider organization. 1 individual provider 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 →
- 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.