Pocatello Wellness Clinic, LLC
NPI 1437615952ActiveOrganization· Nurse Practitioner, Family· Pocatello, ID
Nurse Practitioner, Family in Pocatello, Idaho, registered in NPPES in February 2019. The authorized official on file is Dustin Reno, NP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1437615952 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 20, 2019 |
| Last updated in NPPES | Apr 23, 2024 |
| Certified by provider | Mar 17, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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