Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mountain States Medical Group PA

Organization Family Medicine Physician · NPI 1730272006

Mountain States Medical Group PA provides Family Medicine Physician services in Boise, Idaho. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4809 Fairview Ave
Boise, ID 83706-2242 Not confirmed with CMS for 18 years — call before visiting
Phone: (208) 378-2840
Fax: (208) 323-9070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1730272006
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard McChrystal — President · (208) 378-2840
NPI enumeratedOctober 1, 2006
Last updated in NPPESSeptember 15, 2008
Mailing addressPo Box 4236, Boise, ID 83711-4236

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