Individual provider Active NPI

Michael Glover, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Boise, ID
National Provider Identifier
1013235423
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
M-13346 Issued in ID
Practice address
500 W Fort St
Mail Code #112
Boise, ID 83702
Phone
(208) 422-1000
Fax
(208) 422-1082
NPI assigned
May 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Q2445 TX
Orthopaedic Surgery of the Spine Physician 207XS0117X Q2445 TX
Orthopaedic Surgery of the Spine Physician 207XS0117X M-13346 ID Primary

Addresses

Primary practice location

500 W Fort St
Mail Code #112
Boise, ID 83702

Mailing address

500 W Fort St
Mail Code #112
Boise, ID 83702
Phone (208) 422-1000

Other practice location 1

6400 Fannin St
Suite 1700
Houston, TX 77030-1521
Phone (713) 799-2429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160829001304 ID Practitioner - Orthopedic Surgery 8921393091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q2445TXMDOrthopaedic Surgery Physician
M-13346IDMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Idaho Health Partners LLC CurrentSince Sep 19, 2022 Accepting new patients
Spine Institute of Idaho P a Orthopaedic Surgery of the Spine CurrentSince Oct 3, 2016 Accepting new patients

Locations

360 E Montvue Dr
#100
Meridian, ID 83642
Phone (208) 855-2900

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10048/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1013235423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "MAIL CODE #112",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-422-1000",
            "fax_number": "208-422-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "MAIL CODE #112",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-422-1000",
            "fax_number": "208-422-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Fannin St",
            "address_2": "Suite 1700",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301521",
            "country_code": "US",
            "telephone_number": "713-799-2429",
            "fax_number": "713-790-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "Q2445",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "Q2445",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "ID",
            "license": "M-13346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.