NPI age
3 years
Enumerated 2022-12-26
● Active Type 2 · Organization
Southern Idaho Medicine Pllc
Southern Idaho Medicine Pllc is 1 of 145 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Crismor
Owner
Last NPPES update
2022-12-26
Source: monthly bulk 2026-05
How this organization compares
Across 145 active clinic/center providers in Idaho.
NPI age
3 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-12Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
207 E Main St
Jerome, ID 833382334
Mailing address
137 Woodridge Dr
Twin Falls, ID 833018156
Authorized official
Jessicca Marie Crismor, FNP
Owner
📞 2083087738
Specialties
-
Clinic/Center PrimaryA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct...
Practice context
Single-site organization. Only one practice location on file.
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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.