GOBLE MEDICAL GROUP — NPI 1154712768 (Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) in PERRY, UT)

CMS-1500 Box 24J / 33a • NPI

1154712768

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207P00000X (CMS 93)

Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)

Box 32 Service Location & ZIP+4

1950 S HIGHWAY 89, PERRY, UT, 84302-4119

✓ 9-Digit EDI 837 ZIP+4 (84302-4119)

Practice Phone & Referral Fax

(208) 542-9111

Fax: (208) 542-9114

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154712768 (GOBLE MEDICAL GROUP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154712768` (NPI-2 Organization / Facility)
Provider / Legal Name	GOBLE MEDICAL GROUP
Plain-English Specialty	Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: `207P00000X` (Emergency Medicine)
Certifying / Licensing Body	American Board of Emergency Medicine (ABEM)
Practice Location Address	1950 S HIGHWAY 89, PERRY, UT, 84302-4119
Practice Telephone / Fax	Tel: (208) 542-9111 \| Fax: (208) 542-9114
Administrative Mailing Address	740 S WOODRUFF AVE, IDAHO FALLS, ID, 83401-5285
Enumeration & Last Sync	Enumerated: 2015-02-18 \| CMS Record Updated: 2015-03-09
Authorized Official	EDWIN GOBLE (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1950 S HIGHWAY 89, PERRY, UT, 84302-4119

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Plain-English Taxonomy & CMS Crosswalk (207P00000X)

What Does Taxonomy Code 207P00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 93 (Physician/Emergency Medicine)
Certifying / Accrediting Authority: American Board of Emergency Medicine (ABEM)
Clinical Scope: Immediate life-or-limb emergencies, severe chest pain, stroke symptoms, deep contaminated wounds needing tetanus prophylaxis, or severe dehydration.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GOBLE MEDICAL GROUP)

Typical CPT / Diagnostic Procedures:

Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting

Common Therapeutic Classes:

Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207Q00000X` — Family Medicine Plain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`261QU0200X` — Clinic/Center, Urgent Care Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

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GOBLE MEDICAL GROUP (NPI #1154712768)