NPIMap

Organization Active NPI

Boise Minor Emergency Center PA

  • General Practice Physician
  • Boise, ID
National Provider Identifier
1114938909
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BOISE MINOR EMERGENCY CENTER PA
Practice address
2993 N Cole Rd
Boise, ID 83704-5977
Phone
(208) 378-0400
Fax
(208) 378-7529
NPI assigned
Aug 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gary Canova, MDNPI 1265454680
Title
Owner
Phone
(208) 378-0400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

2993 N Cole Rd
Boise, ID 83704-5977

Mailing address

2993 N Cole Rd
Boise, ID 83704-5977
Phone (208) 378-0400

National Provider Directory

National Provider Directory

Locations

2993 N Cole Rd
Boise, ID 83704
Phone (208) 378-0400

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114938909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2993 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045977",
            "telephone_number": "208-378-0400",
            "fax_number": "208-378-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2993 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045977",
            "telephone_number": "208-378-0400",
            "fax_number": "208-378-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE MINOR EMERGENCY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANOVA",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-378-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.