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

Collin Andrew Fuqua

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1225768252

Collin Andrew Fuqua is a Physician Assistant in Pocatello, Idaho. Qualified in 2023, 3 years ago. Practices with Vidant Medical Group LLC, a 974-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

921 S 8th Ave Stop 8253
Pocatello, ID 83209-0002
Phone: (208) 282-4726
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1225768252
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Vidant Medical Group Llc — 974 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Pocatello