Idaho Street Medical Clinic
NPI 1063970143 · Rural Health Clinic/Center · Homedale, ID
Idaho Street Medical Clinic is a Rural Health Clinic/Center organization in Homedale, ID (NPI 1063970143).
Provider details
- NPI number
- 1063970143
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Edith Roe, President(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
7 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
Other names (DBA / former)
- Doing business as
- Idaho Street Medical Clinic
Registry dates
- Enumerated
- 2019-03-07
- Last updated
- 2019-03-07
Frequently asked questions
- What is Idaho Street Medical Clinic's NPI number?
- Idaho Street Medical Clinic's National Provider Identifier (NPI) is 1063970143, 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 Rural Health 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 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) 859-4103.
- 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, President. 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 (1063970143) is active in the NPPES registry as of the last update on 2019-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.