Family Medicine Hub PLLC
NPI 1134620107ActiveOrganization· Nurse Practitioner· Idaho Falls, ID
Nurse Practitioner in Idaho Falls, Idaho, registered in NPPES in February 2018. The authorized official on file is Shelly Cameron, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1134620107 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 26, 2018 |
| Last updated in NPPES | Nov 12, 2024 |
| Certified by provider | Nov 12, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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