OrganizationActive
Idaho Falls Pediatrics
NPI 1366560971 · Pediatric Adolescent Medicine Physician · Ammon, ID
Provider details
- NPI number
- 1366560971
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ron Porter, Owner(208) 522-4600
- License
- M7271 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
19 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
3067 Eagle Dr
Ammon, ID 83406-1273
Phone: (208) 522-4600
Fax: (208) 552-7521
Street-level locationGet directions
Mailing address
3067 Eagle Dr
Ammon, ID 83406-1273
Registry dates
- Enumerated
- 2007-03-26
- Last updated
- 2024-12-05
- Certified
- 2024-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.