IVY ALLEN, CPM, LM — NPI 1417722851 (Licensed & Credentialed Midwife in IDAHO FALLS, ID)

CMS-1500 Box 24J / 33a • NPI

1417722851

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

176B00000X

Licensed & Credentialed Midwife

Box 32 Service Location & ZIP+4

378 S RIDGE AVE, IDAHO FALLS, ID, 83402-4115

✓ 9-Digit EDI 837 ZIP+4 (83402-4115)

Practice Phone & Referral Fax

(608) 863-1099

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1417722851 (IVY ALLEN, CPM, LM) 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

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1417722851` (NPI-1 Individual Practitioner)
Provider / Legal Name	IVY ALLEN, CPM, LM
Plain-English Specialty	Licensed & Credentialed Midwife NUCC Code: `176B00000X` (Midwife)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	378 S RIDGE AVE, IDAHO FALLS, ID, 83402-4115
Practice Telephone / Fax	Tel: (608) 863-1099
Administrative Mailing Address	3818 E 196 N, RIGBY, ID, 83442-5670
Enumeration & Last Sync	Enumerated: 2023-11-15 \| CMS Record Updated: 2024-12-17

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

378 S RIDGE AVE, IDAHO FALLS, ID, 83402-4115

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Plain-English Taxonomy & CMS Crosswalk (176B00000X)

What Does Taxonomy Code 176B00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 176B00000X translates to:
"Licensed & Credentialed Midwife"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Midwife for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (IVY ALLEN, CPM, LM)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`175M00000X` — Midwife, Lay Plain English: Licensed & Credentialed Midwife, Lay	State: ID \| License: `MID-154` \| Primary: Secondary
`176B00000X` — Midwife Plain English: Licensed & Credentialed Midwife	State: ID \| License: `MID-154` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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IVY ALLEN, CPM, LM (NPI #1417722851)