Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Matthew J Fackrell, DO

Family Medicine Physician in Blackfoot, ID · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1215968045

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Registry record

Entity type Individual (Type 1)

Name Matthew J Fackrell

Credential DO

Sex Male

Practice address 1441 Parkway Dr, Blackfoot, ID, 83221

Phone (208) 785-2600

Fax (208) 785-8185

Enumeration date Jul 6, 2006

Last updated in NPPES Oct 22, 2024

Taxonomy & licenses

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License OP61556804 (WA) Secondary

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License DO221842 (OR) Secondary

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License OS024313 (PA) Secondary

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License DR.0073268 (CO) Primary

DO · Doctor of Osteopathic Medicine: A fully licensed physician trained in osteopathic medical schools, with the same practice rights as an MD. About the DO credential

Other identifiers

Identifier	Type	State	Issuer
1374716	Other	ID	PTAN
807815500	Medicaid	ID	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Matthew Fackrell practice?

The practice location on file with NPPES is in Blackfoot, ID. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Matthew Fackrell?

The National Provider Identifier (NPI) for Matthew Fackrell is 1215968045, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-10-22.