Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

South Park, Inc.

Case Management Agency in Pocatello, ID · enumerated 2007 · authorized official Russell Mccoy, Executive Director.

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

National Provider Identifier

1437291044

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Registry record

Entity type Organization (Type 2)

Legal business name South Park, Inc.

Other name <Unavail>

Practice address 415 S Arthur Ave, Pocatello, ID, 83204

Phone (208) 233-6833

Fax (208) 233-6842

Enumeration date Feb 12, 2007

Last updated in NPPES Sep 11, 2025

Taxonomy & classification

251B00000X Case Management Agency Agencies Primary

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License 15 (ID) Secondary

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License 20 (ID) Secondary

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License 43 (ID) Secondary

Authorized official

Name Russell Mccoy

Title Executive Director

Phone (208) 233-6833

Other identifiers

Identifier	Type	State	Issuer
00259810	Medicaid	ID	-
00259800	Medicaid	ID	-
00259790	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.

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Frequently asked questions

Where is South Park, Inc. located?

The practice location on file with NPPES is in Pocatello, ID.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-09-11. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-11.