Payette Lakes Medical Clinic, PA
NPI 1902937196 · Primary Care Clinic/Center · Donnelly, ID
Payette Lakes Medical Clinic, PA is a Primary Care Clinic/Center organization in Donnelly, ID (NPI 1902937196).
Provider details
- NPI number
- 1902937196
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jacqueline Bruns, Vp - Physician Services(208) 634-4061
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
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
Mailing address
Other names (DBA / former)
- Other name
- Donnelly Medical Clinic
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2008-03-17
Frequently asked questions
- What is Payette Lakes Medical Clinic, PA's NPI number?
- Payette Lakes Medical Clinic, PA's National Provider Identifier (NPI) is 1902937196, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Payette Lakes Medical Clinic, PA?
- Payette Lakes Medical Clinic, PA is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Payette Lakes Medical Clinic, PA located?
- Payette Lakes Medical Clinic, PA's practice location on file with NPPES is 454 Rosebury Road, Donnelly, ID 83615.
- What is Payette Lakes Medical Clinic, PA's phone number?
- The practice phone number listed in the NPPES registry for Payette Lakes Medical Clinic, PA is (208) 325-4455.
- Who is the authorized official for Payette Lakes Medical Clinic, PA?
- The authorized official listed on Payette Lakes Medical Clinic, PA's NPPES record is Jacqueline Bruns, Vp - Physician Services. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Payette Lakes Medical Clinic, PA's NPI active?
- Yes — Payette Lakes Medical Clinic, PA's NPI (1902937196) is active in the NPPES registry as of the last update on 2008-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.