IDAHO PAIN MEDICINE, LLP (NPI# 1588832992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588832992 |
| Entity Type | Organization |
| Organization Name | IDAHO PAIN MEDICINE, LLP |
| Practice Address |
8950 W Emerald St Ste 168 Boise ID 83704-8296 |
| Practice Telephone | 2083236273 |
| Practice Fax Number | 2083236277 |
| Mailing Telephone | 2083236273 |
| Mailing Fax Number | 2083236277 |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |
| Authorized Official Name | DR. SHANE ALAN MAXWELL (CO-OWNER) |
| Authorized Official Telephone | 2083236273 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
8950 W EMERALD ST STE 168 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-8296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740238849 | Patrick Edward Farrell | Pain Medicine | 301 W Myrtle St, Boise, ID 83702-7656 | 2006-05-04 |
| 1477941672 | Beacon Pain Clinic | Pain Medicine | 115 W Main St, 102, Boise, ID 83702-7302 | 2014-12-23 |
| 1194924514 | Dr. Farrell, LLC | Pain Medicine | 301 W Myrtle St, Boise, ID 83702 | 2007-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1508825456 | Shane A Maxwell | Pain Medicine | 3551 E Overland Rd, Meridian, ID 83642-6757 | 2006-03-20 |
| 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 |
| 1366849572 | Exodus Pain Clinic | Pain Medicine | 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 | 2014-12-03 |
| 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 |
| 1629229869 | Interventional Pain Consultants Pa | Pain Medicine | 2841 Juniper Dr, Lewiston, ID 83501-4719 | 2008-10-07 |
| Find all providers with the same taxonomy | ||||
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| 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.