STERLING PROVIDER GROUP; NPI #1952923765

Contact Information

STERLING PROVIDER GROUP

7017 DAISY LANE
IDAHO FALLS, ID 83402

Phone: 208-542-9111
Fax: 208-542-9114
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
Occupational Medicine	261QX0100X
Primary Care	261QP2300X
Urgent Care	261QU0200X

Indicates primary specialty

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NPI Profile & details for STERLING PROVIDER GROUP

NPI # 1952923765

LBN Legal business name STERLING PROVIDER GROUP

Authorized official CORBIN BUNNAGE - (PROVIDER/OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/14/2020

Last updated 04/01/2025 - More than a year ago

Identifiers

Other

13D2184104

CLIA

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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