OrganizationActive
Phs MD #1, LLC
NPI 1124355813 · Primary Care Clinic/Center · Pocatello, ID
Phs MD #1, LLC is a Primary Care Clinic/Center organization in Pocatello, ID (NPI 1124355813).
Provider details
- NPI number
- 1124355813
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Pocatello Health Services, LLC
- Organization subpart
- Yes
- Authorized official
- John Abreu, Cfo(208) 239-2110
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 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
651 Memorial Dr
Pocatello, ID 83201-4071
Phone: (208) 239-2110
Fax: (208) 239-2145
Street-level locationGet directions
Mailing address
Po Box 4168
Pocatello, ID 83205-4168
Other names (DBA / former)
- Other name
- Portneuf Medical Practices
Registry dates
- Enumerated
- 2009-11-17
- Last updated
- 2010-03-02
Frequently asked questions
- What is Phs MD #1, LLC's NPI number?
- Phs MD #1, LLC's National Provider Identifier (NPI) is 1124355813, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phs MD #1, LLC?
- Phs MD #1, LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Phs MD #1, LLC located?
- Phs MD #1, LLC's practice location on file with NPPES is 651 Memorial Dr, Pocatello, ID 83201-4071.
- What is Phs MD #1, LLC's phone number?
- The practice phone number listed in the NPPES registry for Phs MD #1, LLC is (208) 239-2110.
- Who is the authorized official for Phs MD #1, LLC?
- The authorized official listed on Phs MD #1, LLC's NPPES record is John Abreu, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phs MD #1, LLC's NPI active?
- Yes — Phs MD #1, LLC's NPI (1124355813) is active in the NPPES registry as of the last update on 2010-03-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.