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

Individual provider Medical Physician Assistant · NPI 1346375367

Derek Eddie, PA-C is a Physician Assistant in Pocatello, Idaho. Qualified in 2006, 20 years ago. Practices with Cc Pocatello LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
20
Licensed in
ID
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

560 Memorial Dr
Pocatello, ID 83201-4073
Phone: (208) 234-1960
Fax: (208) 233-5033
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-662 (ID)

Record details

NPI number1346375367
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 22, 2007
Last updated in NPPESJuly 8, 2007
Mailing address560 Memorial Dr, Pocatello, ID 83201-4073

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Cc Pocatello Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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