NPI age
19 years
Enumerated 2006-10-01
● Active Type 2 · Organization
Mountain States Medical Group PA
Mountain States Medical Group PA is 1 of 1691 family medicine organizations in Idaho.
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McChrystal
President
Last NPPES update
2008-09-15
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
19 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
4809 Fairview Avenue
Boise, ID 837062242
Mailing address
Po Box 4236
Boise, ID 837114236
Authorized official
Richard McChrystal, PA
President
📞 2083782840
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010017966 | RBSI |
| 01 (ID) | 8C196 | BLUE CROSS |
Practice context
Single-site organization. Only one practice location on file.
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