NPI age
15 years
Enumerated 2010-08-10
● Active Type 2 · Organization
Idaho Falls Surgical Center
Idaho Falls Surgical Center is 1 of 264 durable medical equipment & medical supplies organizations in Idaho.
Primary specialty
Durable Medical Equipment & Medical Supplies
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Petersen
Pres
Last NPPES update
2010-08-10
Source: monthly bulk 2026-05
How this organization compares
Across 264 active durable medical equipment & medical supplies providers in Idaho.
NPI age
15 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2010 → 2026
2010-08Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
1945 E 17th St
Idaho Falls, ID 834046429
Mailing address
Po Box 52180
Idaho Falls, ID 834052180
Authorized official
Mark L Petersen, MD
Pres
📞 2085291945
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Jon Champlin, CRNA Nurse Anesthetist, Certified Registered NPI 1386722429
Specialties
-
Durable Medical Equipment & Medical Supplies PrimaryA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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Request a quote →How to verify this organization
- 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.