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

Laura Ivie, PA-C

Individual provider Physician Assistant · NPI 1205135456

Laura Ivie, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2011, 15 years ago. Practices with Tony C Roisum MD PA, a 5-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
15
Licensed in
ID
In the registry since
2011
Specialties on file
3
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

3360 Washington Pkwy Ste 1
Idaho Falls, ID 83404-8333
Phone: (208) 524-3416
Fax: (208) 524-3138
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-938 (ID)
Physician Assistant Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X (ID)

Record details

NPI number1205135456
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 26, 2011
Last updated in NPPESMarch 8, 2022
Certification dateMarch 8, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Tony C Roisum Md Pa — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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