Xdi Pathology PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

XDI PATHOLOGY PA

Practice address

1151 Miller St
Boise, ID 83702-6965

Phone

(800) 222-7566

NPI assigned

May 30, 2008

Last updated

May 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brad Morton

Title

SVP Ar Applications

Phone

(800) 222-7566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1275791865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2240",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162240",
            "telephone_number": "800-222-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 MILLER ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026965",
            "telephone_number": "800-222-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XDI PATHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "SVP AR APPLICATIONS",
        "authorized_official_telephone_number": "800-222-7566",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wyler, PA-S
• Steven Wyman, MD
• Donraphael Wynn, M.D.
• Elizabeth Mary Wynn
• Amy Wysong, DO
• Xpert Care LLC
• Natasha Renea Yaganeh, LPC
• Karin Lynn Yahr, LCPC
• Melanie Yakemovic, DPT
• Amy Lynn Yameogo, LMSW

• Clinical Medical Laboratory in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.