Boise Intensive Care Hospital, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

BOISE INTENSIVE CARE HOSPITAL, INC.

Practice address

2131 South Bonito Way
Meridian, ID 83642-1659

Phone

(866) 599-9925

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Cronin, CPA

Title

Vice President of Reimbursement

Phone

(469) 241-2128

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Complex Care Hospital of Idaho Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 130070

Legal name

COMPLEX CARE HOSPITAL OF IDAHO

Certification status

Terminated Voluntary: other reason for withdrawal, Jan 31, 2009

Provider type (POS)

Hospital – Short-term

Participating since

Jul 21, 2008

Last certification

Jul 18, 2008

Beds

60

Ownership / control type

Private (not for profit)

Facility address

2131 South Bonito Way
Meridian, ID 83642

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1194908053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 LEGACY DR",
            "address_2": "SUITE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243178",
            "telephone_number": "469-241-2100",
            "fax_number": "469-241-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 SOUTH BONITO WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421659",
            "telephone_number": "866-599-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE INTENSIVE CARE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "CRONIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT OF REIMBURSEMENT",
        "authorized_official_telephone_number": "469-241-2128",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PART B",
            "identifier": "1369006",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complex Care Hospital of Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Boise Id Caregiving LLC
• Boise Id Homecare
• Boise Imaging Solutions LLC
• Boise Imaging Solutions LLC
• Boise Intensive Care Hospital Inc
• Boise Kidney & Hypertension PLLC
• Boise Naturopathic Medicine PC
• Boise Surgical Group
• Boise Valley Anesthesia LLC
• Michelle Louise Boisvert, PT

• General Acute Care Hospital in Meridian, ID
• Providers in Meridian, ID by specialty
• General Acute Care Hospital in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.