Shoshone Bannock Tribes, Inc
NPI 1225414519 · Clinic/Center · Fort Hall, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shoshone Bannock Tribes, Inc is a Clinic/Center organization in Fort Hall, ID (NPI 1225414519).
Provider details
- NPI number
- 1225414519
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Melissa Johnson, Credentialing Manager(517) 896-3464
Specialties & taxonomies
Ambulatory Health Care Facilities
- Federally Qualified Health Center (FQHC)261QF0400X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
- Shoshone-Bannock Community Health Center
Registry dates
- Enumerated
- 2015-08-10
- Last updated
- 2022-01-19
- Certified
- 2022-01-19
Frequently asked questions
- What is Shoshone Bannock Tribes, Inc's NPI number?
- Shoshone Bannock Tribes, Inc's National Provider Identifier (NPI) is 1225414519, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shoshone Bannock Tribes, Inc?
- Shoshone Bannock Tribes, Inc is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Shoshone Bannock Tribes, Inc located?
- Shoshone Bannock Tribes, Inc's practice location on file with NPPES is Navajo Drive Bldg 70, Fort Hall, ID 83203-0306.
- What is Shoshone Bannock Tribes, Inc's phone number?
- The practice phone number listed in the NPPES registry for Shoshone Bannock Tribes, Inc is (208) 478-3995.
- Does Shoshone Bannock Tribes, Inc accept Medicare?
- Shoshone Bannock Tribes, Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Shoshone Bannock Tribes, Inc?
- The authorized official listed on Shoshone Bannock Tribes, Inc's NPPES record is Melissa Johnson, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shoshone Bannock Tribes, Inc's NPI active?
- Yes — Shoshone Bannock Tribes, Inc's NPI (1225414519) is active in the NPPES registry as of the last update on 2022-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.