NPIMap

Organization Active NPI

Orthopedic & Fracture Clinic PA

Doing business as West Idaho Orthopedics & Sports Medicine

  • Specialist
  • Caldwell, ID
National Provider Identifier
1184739351
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ORTHOPEDIC & FRACTURE CLINIC PA
Doing business as
West Idaho Orthopedics & Sports Medicine
Practice address
1906 Fairview Ave Ste 400
Caldwell, ID 83605-5424
Phone
(208) 459-4511
Fax
(208) 459-6602
NPI assigned
Aug 20, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Michael T. Daines, M.D.NPI 1598973992
Title
Partner
Phone
(208) 459-4511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ID Primary

Addresses

Primary practice location

1906 Fairview Ave Ste 400
Caldwell, ID 83605-5424

Mailing address

1906 Fairview Ave Ste 400
Caldwell, ID 83605-5424
Phone (208) 459-4511

Other names 1

  • WEST IDAHO ORTHOPEDICS & SPORTS MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000145 ID Part B Supplier - Clinic/Group Practice 7810800398 Receives reassigned benefits from 7 practitioners
Practice locations: Caldwell, ID; Fruitland, ID; Meridian, ID

National Provider Directory

National Provider Directory

Locations

1906 Fairview Ave
Ste 400
Caldwell, ID 83605
Phone (208) 287-6627

1119 NW 16TH St
Fruitland, ID 83619

3875 E Overland Rd
Ste 106
Meridian, ID 83642
Phone (208) 895-0888

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1184739351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 400",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055424",
            "telephone_number": "208-459-4511",
            "fax_number": "208-459-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 400",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055424",
            "telephone_number": "208-459-4511",
            "fax_number": "208-459-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & FRACTURE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "DAINES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "208-459-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST IDAHO ORTHOPEDICS & SPORTS MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.