Pure Infusion of Idaho LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PURE INFUSION OF IDAHO LLC

Practice address

5975 W Overland Rd
Boise, ID 83709-3012

Phone

(208) 488-4998

NPI assigned

Mar 4, 2026

Organization subpart

No

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

Authorized official

Name

Rachel Fraga

Title

VP of Payer Development

Phone

(801) 590-9267

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1295680197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W TOWNE RIDGE PKWY STE 500",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705531",
            "telephone_number": "801-590-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837093012",
            "telephone_number": "208-488-4998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 E Goldstone Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421224",
            "country_code": "US",
            "telephone_number": "888-209-8874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 Falls Ave E Ste 1151A",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833013455",
            "country_code": "US",
            "telephone_number": "208-543-7995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11118 Moss Ln",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836518015",
            "country_code": "US",
            "telephone_number": "208-563-5910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 W McMillan Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836466891",
            "country_code": "US",
            "telephone_number": "208-900-4480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3423 Merlin Dr",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047430",
            "country_code": "US",
            "telephone_number": "208-217-9099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "916 W Ironwood Dr Ste Ul1",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142642",
            "country_code": "US",
            "telephone_number": "208-577-5380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PURE INFUSION OF IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "FRAGA",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "VP OF PAYER DEVELOPMENT",
        "authorized_official_telephone_number": "801-590-9267"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry P Pulver, MD,PHD
• Hannah A Punk, CRNA
• Carolyn Punt, NP-C
• Adam Ronald Purcell, LCSW
• Pure Healthcare of Idaho LLC
• Pure Motion Chiropractic PC (Pure Motion Chiropractic)
• Pure Path Compounding Pharmacy LLC
• Pure Vita Co.
• Mackenzie Purnell, MS, LPC, NCC
• Marybeth Puzio, CRNA

• Multi-Specialty Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Multi-Specialty Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.