Idaho Street Medical Clinic
NPI 1023639622 · Health Service Clinic/Center · Homedale, ID
Idaho Street Medical Clinic is a Health Service Clinic/Center organization in Homedale, ID (NPI 1023639622).
Provider details
- NPI number
- 1023639622
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Edith Roe, Nurse Practitioner(208) 859-4103
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
Mailing address
Registry dates
- Enumerated
- 2020-05-05
- Last updated
- 2020-05-05
- Certified
- 2020-05-05
Frequently asked questions
- What is Idaho Street Medical Clinic's NPI number?
- Idaho Street Medical Clinic's National Provider Identifier (NPI) is 1023639622, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Idaho Street Medical Clinic?
- Idaho Street Medical Clinic is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Idaho Street Medical Clinic located?
- Idaho Street Medical Clinic's practice location on file with NPPES is 126 W. Idaho Ave, Homedale, ID 83628-8362.
- What is Idaho Street Medical Clinic's phone number?
- The practice phone number listed in the NPPES registry for Idaho Street Medical Clinic is (208) 337-7038.
- Who is the authorized official for Idaho Street Medical Clinic?
- The authorized official listed on Idaho Street Medical Clinic's NPPES record is Edith Roe, Nurse Practitioner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Idaho Street Medical Clinic's NPI active?
- Yes — Idaho Street Medical Clinic's NPI (1023639622) is active in the NPPES registry as of the last update on 2020-05-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.