MR. SHANE A MAXWELL


Address: 3551 E Overland Rd, Meridian, ID 83642-6757
Phone: 2088841333

MR. SHANE A MAXWELL (NPI# 1508825456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508825456
Entity Type Individual
Full Name MR. SHANE A MAXWELL
Credential D.O.
Practice Address 3551 E Overland Rd
Meridian
ID 83642-6757
Mailing Address Po Box 1128
Boise
ID 83701-1128
Practice Telephone 2088841333
Practice Fax Number 2084895188
Mailing Telephone (208) 381-2222
Mailing Fax Number 2084633044
Enumeration Date 2006-03-20
Last Update Date 2017-08-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
O0385 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ID 807415700 05
ID 1508825456 05

Other Providers SHANE MAXWELL

NPI Name Taxonomy Address Enumeration
1689635740 Shane R. Maxwell Family Medicine 3801 Scott and White Dr, Killeen, TX 76543-5252 2006-03-29

Office Location

Street Address 3551 E OVERLAND RD
City MERIDIAN
State ID
Zip Code 83642-6757

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912319740 Garrett Weldon Physical Therapist 3551 E Overland Rd, Meridian, ID 83642-6757 2014-05-28
1770924532 Scott A Stephens Physical Therapist 3551 E Overland Rd, Meridian, ID 83642-6757 2013-07-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174145684 Ikdo South Meridian LLC Dentist 3839 E Amity Rd, Meridian, ID 83642 2020-05-07
1073133328 Prescription Pad LLC Pharmacy 885 S Vanguard Way, Meridian, ID 83642 2020-04-16
1609412683 Meridian Advanced Psychiatry, LLC Psychiatry & Neurology 1672 S Woodsage Ave., Meridan, ID 83642 2019-11-25
1194378927 Sergey Tsema Occupational Therapist 1259 E Pisa St, Meridian, ID 83642 2019-07-21
1003478629 Chris R Jackson Dentist Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 2019-07-03
1285293118 Morgan Family Medicine Nurse Practitioner 1660 S Woodsage Avenue, Meridian, ID 83642 2019-06-13
1033772793 Nugen Healthcare, Pllc Registered Nurse 2177 S Spoonbill Ave, Meridian, ID 83642 2019-04-18
1811471790 Courtney Crossland Physician Assistant 4949 S Hillsdale Ave., Meridian, ID 83642 2018-09-18
1841771938 Katelyn Perry Counselor 2068 S. Eagle Rd., Meridian, ID 83642 2018-08-27
1114406204 Gem Prep: Meridian LLC Case Management 2750 E.gala Ct., Meridian, ID 83642 2018-08-09
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Taxonomy Information

Taxonomy Code 208VP0014X
Grouping Allopathic & Osteopathic Physicians
Classification Pain Medicine
Specialization Interventional Pain Medicine

Taxonomy Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922092881 Eric Pearson Pain Medicine 1001 14th St, Meridian, MS 39301-4458 2005-09-07
1134596760 Pain Partners, LLC Pain Medicine 1001 14th St, Meridian, MS 39301-4458 2015-08-31
1366849572 Exodus Pain Clinic Pain Medicine 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 2014-12-03
1043204654 Kenneth Staggs Jr. Pain Medicine 1001 14th St, Meridian, MS 39301-4458 2005-09-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588832992 Idaho Pain Medicine, LLP Pain Medicine 8950 W Emerald St Ste 168, Boise, ID 83704-8296 2008-02-19
1427273853 Kimberly A Vorse Md PC Pain Medicine 380 Washington Ave Suite 201, Ketchum, ID 83340 2007-04-13
1760403893 Craig G Flinders Pain Medicine 2841 Juniper Dr, Lewiston, ID 83501-4719 2006-07-22
1740238849 Patrick Edward Farrell Pain Medicine 301 W Myrtle St, Boise, ID 83702-7656 2006-05-04
1013556596 Gritman Medical Center Inc Pain Medicine 804 S Washington St Ste A, Moscow, ID 83843-3182 2019-12-31
1639657521 Heather Mckenzie Pain Medicine 2177 W Ironwood Center Dr, Coeur D Alene, ID 83814 2018-08-01
1336519891 Timothy E. Snell, Md, Pllc Pain Medicine 2240 E Center St, Pocatello, ID 83201-2600 2015-09-28
1477941672 Beacon Pain Clinic Pain Medicine 115 W Main St, 102, Boise, ID 83702-7302 2014-12-23
1609191881 Christian Becker Pain Medicine 2060 S Woodruff Ave, Idaho Falls, ID 83404-6396 2010-03-31
1043445513 Ryan D. Hope, M.d., LLC Pain Medicine 285 Vista Dr, Pocatello, ID 83201-4987 2009-05-27
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Competitor

Search similar providers

City MERIDIAN
Zip Code 83642

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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