Community Care Pllc
Community Care Pllc is a healthcare organization registered as Family Medicine Physician in Rexburg, ID, holding Type 2 (organization) NPI 1184647307 since 2006. The authorized official on file is Ryan Peterson, Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1184647307 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Community Care Pllc |
| Practice address | 72 E MAIN ST, Rexburg, ID, 83440 |
| Phone | 2083591770 |
| Fax | 2083591780 |
| Enumeration date | 2006-07-26 |
| Last updated in NPPES | 2020-08-22 |
Authorized official
| Name | Ryan Peterson |
|---|---|
| Title | Ceo |
| Phone | 2085258448 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Primary | — | — |
Copy-ready billing details
Provider: Community Care Pllc NPI: 1184647307 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 72 E MAIN ST, Rexburg, ID, 83440
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1366488926 | Trent Shaw | Individual | Medical Physician Assistant | Rexburg, ID |
| 1972549137 | David Daniels | Individual | Family Medicine Physician | Rexburg, ID |
| 1740554237 | Community Care Rexburg LLC | Organization | Clinic/Center | Rexburg, ID |
| 1659914802 | Mountain View Hospital LLC | Organization | Family Medicine Physician | Rexburg, ID |
Verify this record
Cross-check NPI 1184647307 against the authoritative CMS record: view Community Care Pllc on the official NPPES registry .
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 or validate an NPI number.
Frequently asked questions
What type of organization is Community Care Pllc?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-08-22.