NPI age
16 years
Enumerated 2009-10-16
● Active Type 2 · Organization
Idaho Endoscopy Center Llc
Idaho Endoscopy Center Llc is 1 of 99 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mallory
Manager/doctor
Last NPPES update
2020-07-23
Source: monthly bulk 2026-05
How this organization compares
Across 99 active clinic/center providers in Idaho.
NPI age
16 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-10Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
6259 W Emerald St
Boise, ID 837048731
Mailing address
6259 W Emerald St
Boise, ID 837048731
Authorized official
Mark A Mallory, M.D.
Manager/doctor
📞 2084891900
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Jeffrey Bank, M.D. Internal Medicine NPI 1881089415
- Shannon Bordes, FNP-BC, APRN, MSN Nurse Practitioner NPI 1851831200
- Bryan Brimhall, M.D. Internal Medicine NPI 1902195753
- Victor Chen, MD, M.S.P.H. Internal Medicine NPI 1215916846
- Joseph Cook, MD Internal Medicine NPI 1700867199
- Lauren Cooper, MD Internal Medicine NPI 1841850351
- Nic Cordum, M.D. Internal Medicine NPI 1205803756
- Patrick Denning, PHYSICIAN ASSISTANT Physician Assistant NPI 1508376658
- James Doyle, MD Internal Medicine NPI 1336147560
- Michael Egland, PA-C Physician Assistant NPI 1972192227
- Ashley Evans, MD Internal Medicine NPI 1326238981
- Robb Gibson, M.D. Internal Medicine NPI 1538128707
- Samuel Gibson, M.D. Internal Medicine NPI 1275500738
- Christopher Goulet, M.D. Internal Medicine NPI 1023085180
- Meghan Jankowski Internal Medicine NPI 1518120179
- Edward Krajicek, M.D. Internal Medicine NPI 1487060117
- Wendi Lebrett Internal Medicine NPI 1083119721
- Madeline Lewis, PA-C Physician Assistant NPI 1467161505
- Nancy L'Heureux, DNP Nurse Practitioner NPI 1003282708
- Mark Mallory, M.D. Internal Medicine NPI 1336116888
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1871902 | MEDICARE PTAN |
Practice context
Multi-provider organization. 20 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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