Optimal Heatlh Medical Institure

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

0-264 Issued in ID

Legal business name

OPTIMAL HEATLH MEDICAL INSTITURE

Practice address

3224 N Maple Grove Rd
Boise, ID 83704-4214

Phone

(208) 495-3688

Fax

(208) 475-4924

NPI assigned

Mar 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ralph M Sutherlin, D.O.

Title

Owner/Physician

Phone

(208) 495-3688

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1184865883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 N MAPLE GROVE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044214",
            "telephone_number": "208-495-3688",
            "fax_number": "208-475-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 N MAPLE GROVE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044214",
            "telephone_number": "208-495-3688",
            "fax_number": "208-475-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEATLH MEDICAL INSTITURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "SUTHERLIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "208-495-3688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "ID",
            "license": "0-264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preventive Medicine/Occupational Environmental Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.