Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Portneuf Nephrology Center

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1164413753

Portneuf Nephrology Center is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2005.

Licensed in
ID
In the registry since
2005

Practice location Address checks out

2001 Bench Rd
Pocatello, ID 83201-2033
Phone: (208) 637-1090
Fax: (208) 637-1097
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X · Licence BM7847203 (ID)

Record details

NPI number1164413753
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jan Jacobs — Accounts Receivable Manager · (208) 367-3076
NPI enumeratedNovember 2, 2005
Last updated in NPPESAugust 22, 2020
Mailing address5610 Gage St, Boise, ID 83706-1332

Other providers in Pocatello