East Idaho Orthopaedics, PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

M9781 Issued in ID

Legal business name

EAST IDAHO ORTHOPAEDICS, PLLC

Doing business as

Liljenquist & Redd Orthopedic Surgery

Practice address

2210 Coronado St
Idaho Falls, ID 83404-7430

Phone

(208) 522-3355

Fax

(208) 522-6019

NPI assigned

Aug 22, 2007

Last updated

Nov 12, 2025By 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

Joseph R Liljenquist, MDNPI 1558375568

Title

President

Phone

(208) 522-3355

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Liljenquist & Redd Orthopedic Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 8

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.

• Joseph R Liljenquist, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Idaho Falls, ID
  • NPI 1558375568
  Medicare reassignment Care Compare group NPD Authorized official
• Jonathan Allred Olson

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
  • NPI 1417318171
  Medicare reassignment Care Compare group NPD
• Brigham B Redd, MD

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
  • NPI 1144208059
  Medicare reassignment Care Compare group NPD
• Austin Jay Campbell, PA-C

  • Physician Assistant
  • Idaho Falls, ID
  • NPI 1134825367
  Medicare reassignment Care Compare group
• Chase William Hanson, PA-C

  • Physician Assistant
  • Idaho Falls, ID
  • NPI 1922657501
  Medicare reassignment Care Compare group
• Trae Pilster, PA-C

  • Surgical Physician Assistant
  • Idaho Falls, ID
  • NPI 1578256814
  Medicare reassignment Care Compare group
• Chad Coon, PA-C

  • Physician Assistant
  • Idaho Falls, ID
  • NPI 1740646363
  Medicare reassignment
• Shane Haas, PA-C

  • Physician Assistant
  • Boise, ID
  • NPI 1497153266
  NPD (past)

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1144413154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047430",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047430",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Bond Ave",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834403503",
            "country_code": "US",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST IDAHO ORTHOPAEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "LILJENQUIST",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-522-3355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-10197",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "ID",
            "license": "M9781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807709400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liljenquist & Redd Orthopedic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liljenquist & Redd Orthopedic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• East Falls Plastic Surgery LLC
• East Idaho Center for Sleep LLC
• East Idaho Orthopaedics PLLC (Liljenquist & Redd Orthopedic Surgery)
• East Idaho Residential Habilitation LLC
• East Idaho Surgical Assisting, LLC
• East Idaho Wound Care LLC
• East Idaho Youth Homes LLC
• Eastern Idaho Cardiology Associates, PLLC

• Sports Medicine (Orthopaedic Surgery) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.