NPI age
19 years
Enumerated 2006-07-03
● Active Type 2 · Organization
St Benedicts Family Medical Center
St Benedicts Family Medical Center is 1 of 61 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Stevenson
Ceo
Last NPPES update
2008-05-08
Source: monthly bulk 2026-05
How this organization compares
Across 61 active clinic/center providers in Idaho.
NPI age
19 years
↑ 12 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
115 5th Ave W
Jerome, ID 833381824
Mailing address
115 5th Ave W
Jerome, ID 833381824
Authorized official
Warren Alan Stevenson
Ceo
📞 2083241122
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807893400 | |
| 05 (ID) | 002287100 | |
| 01 (ID) | 8A489 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010006293 | REGENCE BLUE SHIELD OF ID |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
FIFTH AVENUE CLINIC
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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.