Sterling Provider Group
LBN: Sterling Provider Group
Sterling Provider Group is an health care organization with primary practice located at 740 S Woodruff Ave , Idaho Falls ID 83401-5285. The organization recently has 4 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Urgent Care, Ambulatory Health Care Facilities / Occupational Medicine. Ambulatory Health Care Facilities / Urgent Care is the primary health care specialty.
Sterling Provider Group can be contacted via phone (208) 542-9111, or through Bunnage, Corbin via phone (208) 542-9111.
Contact Information
Primary practice address
740 S Woodruff Ave
Idaho Falls ID 83401-5285
Phone: (208) 542-9111
Fax: (208) 542-9114
Website:
Authorized official contact:
Name: Bunnage, Corbin Physician's Assistant Certified (PA-C)
Phone: (208) 542-9111
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Ambulatory Health Care Facilities / Urgent Care | 261QU0200X | ||
| Ambulatory Health Care Facilities / Occupational Medicine | 261QX0100X |
Profile Details
| NPI number | 1205300407 |
|---|---|
| LBN Legal business name | Sterling Provider Group |
| DBA Doing business as | |
| Authorized official | Bunnage, Corbin Physician's Assistant Certified (PA-C) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 22nd, 2019 |
| Last updated | Jun 17th, 2026 - about 4 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205300407 | NPPES |
| Idaho | Other | 13D0989496 | CLIA |
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