LESLIE JEAN MCGOVERN PA-C MHE ATC LAT NPI 1831184712

NPI Information

NPI: 1831184712
Provider Name: LESLIE JEAN MCGOVERN, PA-C, MHE, ATC, LAT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
777 HOSPITAL WAY
POCATELLO, ID
ZIP 83201
Phone: (480) 421-9700
Get Directions

Leslie Jean Mcgovern, PA-C, MHE, ATC, LAT is a medical physician assistant in Pocatello, ID. Leslie Jean Mcgovern, PA-C, MHE, ATC, LAT NPI is 1831184712. 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:

777 HOSPITAL WAY
POCATELLO, ID
ZIP 83201-175
Phone: (480) 421-9700
Fax: (480) 421-9899

The NPI 1831184712 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 9/15/2005 and was last updated on 7/19/2011.

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	2255A2300X	Specialist/Technologist	Athletic Trainer			No
2	363AS0400X	Physician Assistant	Surgical	PA868	IDAHO	No
3	363AM0700X	Physician Assistant	Medical	PA868	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	1667785	MEDICARE PIN
2	1831184712	MEDICAID	IDAHO
3	16677851	MEDICARE PIN
4	P00902985	OTHER		RAILROAD MEDICARE
5	16677852	MEDICARE PIN	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: 11/14/2023

NPI Synchronization or Removal

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