Intermountian Pediatric Clinic PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTERMOUNTIAN PEDIATRIC CLINIC PA

Practice address

7722 W Ustick Rd
Boise, ID 83704-5845

Phone

(208) 322-1325

Fax

(208) 327-0393

NPI assigned

Jul 5, 2024

Last updated

Jul 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen Louise Jambura, RN BSN

Title

Office Manager

Phone

(208) 322-1325

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexander Combs, DO

  • Family Medicine Physician
  • Boise, ID
  • NPI 1306331186
  NPD
• John P Jambura, MD

  • Pediatrics Physician
  • Boise, ID
  • NPI 1487693099
  NPD (past)

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1093551319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045845",
            "telephone_number": "208-322-1325",
            "fax_number": "208-327-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7722 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045845",
            "telephone_number": "208-322-1325",
            "fax_number": "208-327-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTIAN PEDIATRIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "JAMBURA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-322-1325",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intermountain Ocular Prosthetics, Inc.
• Intermountain Ocular Prosthetics, Inc.
• Intermountain Orthopaedic PLLC
• Intermountain Orthopaedics Specialists
• Intermountain Surgery Center
• International Rescue Committee, Inc.
• Introspective Counseling & Consulting LLC
• Crystal Ipsen, LPC
• Melannee Ipsen
• Iris Interpreting, LLC.

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.