IDAHO PHYSICAL MEDICINE AND REHABILITATION PA NPI 1497949705

NPI Information

NPI: 1497949705
Provider Name: IDAHO PHYSICAL MEDICINE AND REHABILITATION PA
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
3551 E OVERLAND ROAD
MERIDIAN, ID
ZIP 83642
Phone: (208) 884-1333
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IDAHO PHYSICAL MEDICINE AND REHABILITATION PA is an ambulatory surgical clinic center in Meridian, ID. IDAHO PHYSICAL MEDICINE AND REHABILITATION PA NPI is 1497949705. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3551 E OVERLAND ROAD
MERIDIAN, ID
ZIP 83642
Phone: (208) 884-1333

The provider's authorized official is Kate A Shelton .
The authorized official title is Administrator and has the following contact phone number (208) 287-6558.

The enumeration date for this NPI number is 8/29/2007 and was last updated on 6/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine			No
2	261QA1903X	Clinic/Center	Ambulatory Surgical		IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1870010	MEDICARE PIN	IDAHO
2	P00612157	OTHER	IDAHO	RAILROAD MEDICARE
3	808002500	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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