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

Matthew J Fackrell, DO

Individual provider Family Medicine Physician · NPI 1215968045

Matthew J Fackrell, DO is a General Practice in Blackfoot, Idaho. Qualified in 2004, 22 years ago. Practices with Mvh Bmc LLC, a 15-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Colorado, Oregon, Pennsylvania and Washington.

Years since qualifying
22
Licensed in
CO, OR, PA, WA
In the registry since
2006
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1441 Parkway Dr
Blackfoot, ID 83221-1667
Phone: (208) 785-2600
Fax: (208) 785-8185
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 13741 E Rice Pl Ste 101, Aurora, CO 80015-1082 — (800) 640-3451
  • 11417 124th Ave Ne Ste 100, Kirkland, WA 98033-4677 — (800) 640-3451

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DR.0073268 (CO)
Family Medicine Physician Taxonomy 207Q00000X · Licence OP61556804 (WA)
Family Medicine Physician Taxonomy 207Q00000X · Licence DO221842 (OR)
Family Medicine Physician Taxonomy 207Q00000X · Licence OS024313 (PA)

Record details

NPI number1215968045
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 6, 2006
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024
Mailing address1441 Parkway Dr, Blackfoot, ID 83221-1667

Medicare enrollment

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

Medicare specialtyGENERAL PRACTICE
Also practisesOSTEOPATHIC MANIPULATIVE MEDICINE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Mvh Bmc Llc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Blackfoot