P Praxis·MD
● Active Type 2 · Organization

Pocatello Podiatry Associates PA

Podiatrist·Pocatello, ID· NPI 1912194085 · Enumerated 2007 · 18 years on NPI
Pocatello Podiatry Associates PA is 1 of 67 podiatrist organizations in Idaho.
NPI age
18 years
Enumerated 2007-10-02
Primary specialty
Podiatrist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Godfrey
Credentialing
Last NPPES update
2021-03-18
Source: monthly bulk 2026-05

How this organization compares

Across 67 active podiatrist providers in Idaho.

NPI age
18 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2007 → 2026

2007-10Enumerated in NPPES
2007 2026

Where they practice

Primary practice location
1555 E Clark St
Pocatello, ID 832014133
📞 2082334355fax 2082337198
Mailing address
1555 E Clark St
Pocatello, ID 832014133
📞 2082334355fax 2082337198

Authorized official

Koree Godfrey
Credentialing
📞 2082334355

Individual providers at this organization

4 individual providers on file at this primary practice address.

Specialties

  • Podiatrist Primary
    Definition to come...
    ID license #P-82 taxonomy 213ES0103X

Identifiers

TypeValueNotes
05 (ID) 004400900

Other names on file (3)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Ambulatory Foot and Ankle Clinic
    Type code 3 recorded 2021-03-18
  • Ambulatory Foot and Ankle Clinic
    Type code 5 recorded 2021-03-18
  • Ambulatory Foot and Ankle Clinic
    Type code 5 recorded 2008-05-22

Practice context

Multi-provider organization. 4 individual providers on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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