Idaho Surgicenter North LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

P 186 Issued in ID

Legal business name

IDAHO SURGICENTER NORTH LLC

Practice address

3369 Merlin Dr
Idaho Falls, ID 83404-7405

Phone

(208) 529-0009

Fax

(208) 529-2252

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tony D Quinton, DPMNPI 1639157621

Title

Owner

Phone

(208) 529-0009

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tony Dale Quinton, DPM

  • Foot & Ankle Surgery Podiatrist
  • Idaho Falls, ID
  • NPI 1639157621
  NPD (past) Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194735522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1386",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031386",
            "telephone_number": "208-529-0009",
            "fax_number": "208-529-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 MERLIN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-529-0009",
            "fax_number": "208-529-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO SURGICENTER NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUINTON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-0009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ID",
            "license": "P 186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010027109",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "04085",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Idaho Psychiatric Institute
• Idaho Recovery Center, LLC.
• Idaho Urgent Care
• Idaho Vacation Rentals LLC
• Ideal Solutions, Inc.
• If Hospice Opco LLC
• Ifcc PLLC

• Ambulatory Surgical Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• 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.