Paivi Brack

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1407 West McMillan Road
Suite 120
Meridian, ID 83646

Phone

(208) 315-6717

Fax

(208) 315-6718

NPI assigned

Sep 26, 2024

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heidi Bracka Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Restoring Hope - Healing From Trauma and Addiction

  • Mental Health Counselor
  • Meridian, ID
  • NPI 1750927372
  NPD

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1073331344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1662",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83680",
            "telephone_number": "208-315-6717",
            "fax_number": "208-315-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 WEST MCMILLAN ROAD",
            "address_2": "SUITE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "208-315-6717",
            "fax_number": "208-315-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACK",
        "first_name": "PAIVI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "BRACKA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cherie Elizabeth Boyer, RN
• Lilly Boyer
• Cheriese Kay Boyle
• Jeremy Boyle, PHARMD
• Noah Brace
• Isobel Leoncia Marie Bradach
• Jennifer Kay Bradley, RN, BSN
• Karen Louise Bradley, L.C.P.C.
• William Daniel Bradley, M.D.
• Allaina Bradshaw

• Case Manager/Care Coordinator in Meridian, ID
• Providers in Meridian, ID by specialty
• Case Manager/Care Coordinator in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.