NPI age
19 years
Enumerated 2007-03-08
● Active Type 2 · Organization
Payette Lakes Medical Clinic, PA
Payette Lakes Medical Clinic, PA is 1 of 104 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bruns
Vp - Physician Services
Last NPPES update
2008-03-17
Source: monthly bulk 2026-05
How this organization compares
Across 104 active clinic/center providers in Idaho.
NPI age
19 years
↑ 8 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
320 Virginia Avenue
New Meadows, ID 83654
Mailing address
P O Box 1047
McCall, ID 836381047
Authorized official
Jacqueline R Bruns
Vp - Physician Services
📞 2086344061
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010006721 | BS |
| 01 (ID) | 28340 | BC |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Meadows Valley Medical Clinic
Practice context
Single-site organization. Only one practice location on file.
Provyx · Custom healthcare lists
Need all 104 Clinic/Center providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
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.