OrganizationActive
Medical Imaging Assoc of Idaho Falls, PA
NPI 1043400484 · Physician Assistant · Pocatello, ID
Provider details
- NPI number
- 1043400484
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Medical Imaging Associates of Idaho Falls
- Organization subpart
- Yes
- Authorized official
- Karen Vaughn, Authorized Official(330) 309-6984
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
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
18 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
777 Hospital Way
Pocatello, ID 83201-5175
Phone: (208) 227-2600
Street-level locationGet directions
Mailing address
Po Box 85495
Chicago, IL 60689-5495
Registry dates
- Enumerated
- 2007-08-01
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.