Organization provider

SOUTH PARK, INC.

CMS NPPES lists SOUTH PARK, INC. as an organization provider record with NPI 1003021676. The current record reports a primary practice location in POCATELLO, ID and primary taxonomy code 251B00000X.

NPI 1003021676Record type Type 2Primary taxonomy 251B00000X

Type 2 NPIs identify organizations such as practices, groups, and facilities; the NPI type alone does not establish a specific organization category. How to read this profile

01

Other reported names

  • Developmental OptionsDoing-business-as name

02

Practice locations

  1. Primary practice location
    415 S ARTHUR AVEPOCATELLO, ID 832043303

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

03

Taxonomy information

  • 251B00000XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

04

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
May 14, 2007

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.