Bone Density of North Idaho LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

O-45 Issued in ID

Legal business name

BONE DENSITY OF NORTH IDAHO LLC

Practice address

1401 Lincoln Way
Coeur D Alene, ID 83814-2334

Phone

(208) 664-5904

Fax

(208) 292-0797

NPI assigned

Jul 24, 2009

Organization subpart

Yes

Parent organization

NORTH IDAHO FAMILY PHYSICIANS LLCAs reported in NPPES

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

Authorized official

Name

Eric Koelsch

Title

Executive Director

Phone

(208) 676-0145

Specialties & licenses 1

Addresses

Part of

North Idaho Family Physic

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1093945016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "SUITE 272E",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-676-0102",
            "fax_number": "208-676-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142334",
            "telephone_number": "208-664-5904",
            "fax_number": "208-292-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONE DENSITY OF NORTH IDAHO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH IDAHO FAMILY PHYSICIANS LLC",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "KOELSCH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-676-0145"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "O-45",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarah L. Boerner, RD
• Christopher Aldon Boggess, DC
• Grant Daniel Bolle, DDS
• Matina Bolster, LPC
• Melanie Carin Bond, MOT, OTR/L
• Ryan Bones, DC
• Courtney Bonin
• Kelli Marie E Booth, LMT
• Denny Bordeaux, RN, PARAMEDIC
• Borders Chiropractic P.C.

• Diagnostic Radiology Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.