FALLS CENTRE FOR FUNCTIONAL MEDICINE PLLC. NPI 1962916304

NPI Information

NPI: 1962916304
Provider Name: FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 13D0975616

Address:
236 MARTIN ST
TWIN FALLS, ID
ZIP 83301
Phone: (208) 733-4444
Get Directions

FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC. is a family medicine in Twin 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. FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC. NPI is 1962916304. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

236 MARTIN ST
TWIN FALLS, ID
ZIP 83301-542
Phone: (208) 733-4444
Fax: (208) 733-4456

The provider's authorized official is Geoffrey Neil Hicks .
The authorized official title is Provider and has the following contact phone number (208) 733-4444.

The CLIA number assigned to this NPI record is 13D0975616 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/21/2017 and was last updated on 2/14/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		O-180	IDAHO	Yes
2	208VP0000X	Pain Medicine	Pain Medicine	O-180	IDAHO	No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	807183500	MEDICAID	IDAHO
2	1730283250	MEDICAID	IDAHO

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

NPI Synchronization or Removal

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