Idahormones

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

IDAHORMONES

Practice address

3648 N Centrepoint Way Ste 110
Meridian, ID 83646-7626

Phone

(208) 874-2394

NPI assigned

Aug 7, 2023

Organization subpart

No

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

Authorized official

Name

Jamie Ruiz, PANPI 1194034249

Title

Owner

Phone

(208) 874-2394

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Lynn Ruiz, P.A.-C

  • Medical Physician Assistant
  • Meridian, ID
  • NPI 1194034249

  Physician Assistant

  NPD Authorized official

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1114600277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4954 W GREY TOWERS DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429281",
            "telephone_number": "208-874-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 N CENTREPOINT WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467626",
            "telephone_number": "208-874-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHORMONES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-874-2394",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Technical Career Academy
• Idaho Transition Care, LLC
• Idaho Urologic Institute PA
• Idaho Voice and Swallow Center LLC
• Idahoinhomecare., LLC
• Idol Transportation, LLC.
• Ikdo South Meridian LLC
• Christopher M Ilgenfritz, CRNA
• Blake Imam, DMD
• Daniel Ilebemhe Imonigie

• All providers in Meridian, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.