Active NPI
Off the Field Sports Medicine PLLC
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Meridian, ID
National Provider Identifier
1104731561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Legal business name
- OFF THE FIELD SPORTS MEDICINE PLLC
- Practice address
- 2204 E Lanark St
Meridian, ID 83642-5916 - Phone
- (208) 466-0200
- NPI assigned
- Aug 18, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandy Roll
- Title
- Billing
- Phone
- (208) 466-0200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | Primary |
Addresses
Primary practice location
2204 E Lanark St
Meridian, ID 83642-5916
Mailing address
2204 E Lanark St
Meridian, ID 83642-5916
Phone (208) 466-0200
National Provider Directory
National Provider DirectoryLocations
2204 E Lanark St
Meridian, ID 83642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787011200000",
"number": "1104731561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 E LANARK ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425916",
"telephone_number": "208-466-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 E LANARK ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425916",
"telephone_number": "208-466-0200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OFF THE FIELD SPORTS MEDICINE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-18",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A",
"authorized_official_last_name": "ROLL",
"authorized_official_first_name": "SANDY",
"authorized_official_title_or_position": "BILLING",
"authorized_official_telephone_number": "208-466-0200"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.