LAURA A TABOR P.A. NPI 1538121322

NPI Information

NPI: 1538121322
Provider Name: LAURA A TABOR, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID
ZIP 83401
Phone: (208) 524-6633
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Laura A Tabor, P.A. is a medical physician assistant in Idaho Falls, ID with 22 years of experience. Laura A Tabor, P.A. NPI is 1538121322. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1880 JOHN ADAMS PKWY
IDAHO FALLS, ID
ZIP 83401-315
Phone: (208) 524-6633
Fax: (208) 524-9952

The NPI 1538121322 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 7/19/2010.

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	363AM0700X	Physician Assistant	Medical	PA415	IDAHO	Yes

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	000010027582	OTHER	IDAHO	REGENCE BLUESHIELD GROUP
2	DE1614	OTHER	IDAHO	RAILROAD MCR GROUP
3	000010156316	OTHER	IDAHO	REGENCE BLUE SHIELD
4	P00205234	OTHER	IDAHO	RAILROAD MEDICARE NUMBER
5	807659300	MEDICAID	IDAHO
6	806887600	MEDICAID	IDAHO
7	1376964	MEDICARE ID-TYPE UNSPECIFIED	IDAHO	DR. BAKER GROUP MCR NUMBE
8	8K123	OTHER	IDAHO	BLUE CROSS GROUP
9	P80646	MEDICARE UPIN	IDAHO
10	1134140148	OTHER	IDAHO	BAKER FAMILY GROUP NPI
11	1667801	MEDICARE ID-TYPE UNSPECIFIED	IDAHO	MEDICARE PROVIDER NUMBER
12	PAC63	OTHER	IDAHO	BLUE CROSS PROVIDER NUMBE

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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