NPI age
20 years
Enumerated 2006-03-15
● Active
Type 1 · Individual
Leslie Irene Burnside, PA-C
Burnside is 1 of 9 physician assistant providers in Chubbuck and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
ID, AL
2 states
Status
Active
No deactivations on record
Last NPPES update
2014-07-22
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
20 years
↑ 11 yr above median (9 yr)
State licenses
2 states
Top 81% — 19% of peers are multi-state
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-03Enumerated in NPPES
2006
2026
Where they practice
Practice location
147 W Chubbuck Rd
Chubbuck, ID 832022314
Mailing address
147 W Chubbuck Rd
Chubbuck, ID 832022314
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807303300 | |
| 01 (ID) | 000010152873 | REGENCE BLUE SHIELD |
| 01 (ID) | PAA34 | BLUE CROSS |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.