Individual provider Active NPI

Russell Bolton Harmony, NP

  • Interventional Pain Medicine Physician
  • Meridian, ID
National Provider Identifier
1194065730
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
NP-1275A Issued in ID
Practice address
1859 S Topaz Way Ste 106
Meridian, ID 83642-4401
Phone
(208) 672-4640
Fax
(208) 957-6300
NPI assigned
Feb 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 774657 CA
Family Nurse Practitioner 363LF0000X 21853 CA
Family Nurse Practitioner 363LF0000X NP-1275A ID
Interventional Pain Medicine Physician 208VP0014X NP-1275A ID Primary

Addresses

Primary practice location

1859 S Topaz Way Ste 106
Meridian, ID 83642-4401

Mailing address

6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907
Phone (208) 672-4640

Other practice location 1

6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907
Phone (208) 672-4640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130709000076 ID Practitioner - Nurse Practitioner 1254571664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Spine and Pain PLLCGroup PAC ID 5698069771, 3 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 672-4640

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • Treasure Valley Hospital Hospital, Boise, ID, CCN 130063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
774657CAMDRegistered Nurse
NP-1275AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elaine Key MD PLLC CurrentSince May 12, 2024 Accepting new patients
Idaho Spine & Pain PLLC Pain Medicine CurrentSince Sep 15, 2017 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

6140 W Curtisian Ave
Ste 400
Boise, ID 83704
Phone (208) 327-5600

1859 S Topaz Way
Ste 106
Meridian, ID 83642
Phone (208) 475-3720

3875 E Overland Rd
Meridian, ID 83642
Phone (208) 327-5600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1194065730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN AVE STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048907",
            "telephone_number": "208-672-4640",
            "fax_number": "208-327-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 S TOPAZ WAY STE 106",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424401",
            "telephone_number": "208-672-4640",
            "fax_number": "208-957-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 W Curtisian Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048907",
            "country_code": "US",
            "telephone_number": "208-672-4640",
            "fax_number": "208-327-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARMONY",
        "first_name": "RUSSELL",
        "middle_name": "BOLTON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-19",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "774657",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21853",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1275A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "ID",
            "license": "NP-1275A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.