Idaho Consumer Direct Personal Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IDAHO CONSUMER DIRECT PERSONAL CARE, LLC

Practice address

280 E Corporate Dr Ste 150
Meridian, ID 83642-2952

Phone

(208) 898-0470

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Ben Bledsoe

Title

President/Ceo

Phone

(406) 532-2001

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Consumer Direct Personal Care, LLC Doing business as

Locations

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1083884597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CONSUMER DIRECT WAY",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085037",
            "telephone_number": "406-532-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 E CORPORATE DR STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422952",
            "telephone_number": "208-898-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO CONSUMER DIRECT PERSONAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "406-532-2001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8079334-00",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8079334-01",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consumer Direct Personal Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Idaho Anesthesia Partners LLC
• Idaho Anti-Trafficking Coalition
• Idaho Arthritis & Osteoporosis Center PC
• Idaho Bariatric and Metabolic Institute L.L.C.
• Idaho Commission on Aging
• Idaho Counseling and Neurofeedback
• Idaho Dental Anesthesia PLLC
• Idaho Dental Professionals, P.C.
• Idaho Dental Professionals, P.C.
• Idaho Dental Professionals, P.C.

• All providers in Meridian, ID
• Home Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.