FAMILY HEALTH SERVICES CORPORATION — NPI 1245804400 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in BELLEVUE, ID)

CMS-1500 Box 24J / 33a • NPI

1245804400

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QF0400X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

621 N MAIN ST, BELLEVUE, ID, 83313-5093

✓ 9-Digit EDI 837 ZIP+4 (83313-5093)

Practice Phone & Referral Fax

(208) 737-6718

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1245804400 (FAMILY HEALTH SERVICES CORPORATION) 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	`1245804400` (NPI-2 Organization / Facility)
Provider / Legal Name	FAMILY HEALTH SERVICES CORPORATION
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QF0400X` (Clinic/Center, Federally Qualified Health Center (FQHC))
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	621 N MAIN ST, BELLEVUE, ID, 83313-5093
Practice Telephone / Fax	Tel: (208) 737-6718
Administrative Mailing Address	794 EASTLAND DR, TWIN FALLS, ID, 83301-6856
Enumeration & Last Sync	Enumerated: 2021-05-13 \| CMS Record Updated: 2021-05-26
Authorized Official	STACEY BLACKWOOD (credentialing specialist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

621 N MAIN ST, BELLEVUE, ID, 83313-5093

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Plain-English Taxonomy & CMS Crosswalk (261QF0400X)

What Does Taxonomy Code 261QF0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QF0400X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Federally Qualified Health Center)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (FAMILY HEALTH SERVICES CORPORATION)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: N/A \| License: `Verified` \| Primary: Secondary
`103TB0200X` — Psychologist, Cognitive & Behavioral Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral	State: N/A \| License: `Verified` \| Primary: Secondary
`101YA0400X` — Counselor, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)	State: N/A \| License: `Verified` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: N/A \| License: `Verified` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: N/A \| License: `Verified` \| Primary: Secondary
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: N/A \| License: `Verified` \| Primary: Secondary
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: N/A \| License: `Verified` \| Primary: Secondary
`124Q00000X` — Dental Hygienist Plain English: Licensed & Credentialed Dental Hygienist	State: N/A \| License: `Verified` \| Primary: Secondary
`133V00000X` — Dietitian, Registered Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered	State: N/A \| License: `Verified` \| Primary: Secondary
`183500000X` — Pharmacist Plain English: Licensed & Credentialed Pharmacist	State: N/A \| License: `Verified` \| Primary: Secondary
`207Q00000X` — Family Medicine Plain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`363AM0700X` — Physician Assistant, Medical Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical	State: N/A \| License: `Verified` \| Primary: Secondary
`363LF0000X` — Nurse Practitioner, Family Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family	State: N/A \| License: `Verified` \| Primary: Secondary
`261QF0400X` — Clinic/Center, Federally Qualified Health Center (FQHC) Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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FAMILY HEALTH SERVICES CORPORATION (NPI #1245804400)