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MACHEN FAMILY MEDICINE PC NPI 1013204445


NPI Information

NPI: 1013204445
Provider Name: MACHEN FAMILY MEDICINE, PC

Doing Business As: SHANE G MACHEN, DO

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 13D0870437

Address:
1995 E 17TH ST STE A
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 522-7666
Get Directions

MACHEN FAMILY MEDICINE, PC is a family medicine in Idaho Falls, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MACHEN FAMILY MEDICINE, PC NPI is 1013204445. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Shane G Machen, Do.

The provider's business location address is:

1995 E 17TH ST STE A
IDAHO FALLS, ID
ZIP 83404-493
Phone: (208) 522-7666
Fax: (208) 524-2821

The provider's authorized official is Shane G Machen .
The authorized official title is Owner and has the following contact phone number (208) 522-7666.

The CLIA number assigned to this NPI record is 13D0870437 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/6/2011 and was last updated on 4/26/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineO-0611IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11196447MEDICARE PINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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