Fall Creek Skin and Health PLLC
NPI 1629247093ActiveOrganization· Physician Assistant, Medical· Rexburg, ID
Physician Assistant, Medical in Rexburg, Idaho, registered in NPPES in February 2008. The authorized official on file is Brett Gerald Bagley, P.A.-C., Physician Assistant Certified. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629247093 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 29, 2008 |
| Last updated in NPPES | Jun 26, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | PA-215 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other physician assistants in Rexburg
- 1184122756
- 1366488926
- 1760533400
- 1932254133
- 1447296785
- 1780965038
- 1609998731
- 1780691394
- 1114297660
- 1972770881