IDAHO PHYSICAL MEDICINE AND REHABILITATION PA – NPI #1497949705
Clinic/Center

IDAHO PHYSICAL MEDICINE AND REHABILITATION PA is an AHC clinic located in MERIDIAN, ID. NPPES has assigned the NPI number 1497949705 to IDAHO PHYSICAL MEDICINE AND REHABILITATION PA on August 29, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 12 years ago on Jun 05, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for IDAHO PHYSICAL MEDICINE AND REHABILITATION PA below.

NPI Profile for
IDAHO PHYSICAL MEDICINE AND REHABILITATION PA

NPI Number
1497949705
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
IDAHO PHYSICAL MEDICINE AND REHABILITATION PA
Primary location
3551 E OVERLAND ROAD
MERIDIAN, ID 83642
Phone: (208) 884-1333 Fax:
Mailing address
PO BOX 1128
BOISE, ID 83701-1128
Phone: (208) 489-4016 Fax: (208) 489-4015
Organization Subpart
Yes - IDAHO PHYSICAL MEDICINE AND REHABILITATION PA is subpart of another organization.
Authorized Official
KATE SHELTON
ADMINISTRATOR
Phone: (208) 287-6558
Updated
Identifiers

Identifiers for IDAHO PHYSICAL MEDICINE AND REHABILITATION PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERRAILROAD MEDICAREIDP00612157
MEDICAIDID808002500
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
ID
2081P2900X
- Physical Medicine & Rehabilitation / Pain Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.