OrganizationActive
South Park, Inc.
NPI 1003021676 · Case Management Agency · Pocatello, ID
South Park, Inc. is a Case Management Agency organization in Pocatello, ID (NPI 1003021676).
Provider details
- NPI number
- 1003021676
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Russell Mccoy, Executive Director(208) 233-6833
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
415 S Arthur Ave
Pocatello, ID 83204-3303
Phone: (208) 233-6833
Fax: (208) 233-6842
Street-level locationGet directions
Mailing address
415 S Arthur Ave
Pocatello, ID 83204-3303
Other names (DBA / former)
- Doing business as
- Developmental Options
Registry dates
- Enumerated
- 2007-05-14
- Last updated
- 2020-08-22
Frequently asked questions
- What is South Park, Inc.'s NPI number?
- South Park, Inc.'s National Provider Identifier (NPI) is 1003021676, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Park, Inc.?
- South Park, Inc. is classified in the NPPES registry as Case Management Agency (Agencies).
- Where is South Park, Inc. located?
- South Park, Inc.'s practice location on file with NPPES is 415 S Arthur Ave, Pocatello, ID 83204-3303.
- What is South Park, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for South Park, Inc. is (208) 233-6833.
- Who is the authorized official for South Park, Inc.?
- The authorized official listed on South Park, Inc.'s NPPES record is Russell Mccoy, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Park, Inc.'s NPI active?
- Yes — South Park, Inc.'s NPI (1003021676) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.