NPIMap

Organization Active NPI

Pathways of Idaho, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
National Provider Identifier
1326466988
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHWAYS OF IDAHO, LLC
Practice address
545 N Benjamin LN Ste 185
Boise, ID 83704-9625
Phone
(208) 322-1026
Fax
(208) 322-1029
NPI assigned
Apr 1, 2014
Organization subpart
Yes
Parent organization
PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Mr. Ryan Jones
Title
Idaho State Director
Phone
(208) 322-1026

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

545 N Benjamin LN Ste 185
Boise, ID 83704-9625

Mailing address

545 N Benjamin LN Ste 185
Boise, ID 83704-9625
Phone (208) 322-1026

Other practice location 1

204 10th Ave S
Nampa, ID 83651-3832
Phone (208) 466-2229

Other practice location 2

7192 W Potomac Dr
Boise, ID 83704-9147
Phone (833) 527-4747

Other practice location 3

540 S 16th St Ste 118
Payette, ID 83661-3514
Phone (208) 462-5079

Other practice location 4

1305 S Kimball Ave
Caldwell, ID 83605-4542
Phone (208) 459-1039

Other identifiers 1

IdentifierTypeStateIssuer
20004720OtherIDMEDICARE PTAN

Other names 1

  • Clarvida Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ID_Inquiry@pathways.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140612001789 ID Part B Supplier - Clinic/Group Practice 4789808759 Receives reassigned benefits from 14 practitioners
Practice locations: Caldwell, ID; Nampa, ID; Payette, ID; Boise, ID

National Provider Directory

National Provider Directory
Tax ID family
Clarvida4 organizations share this tax ID, including this one
Part of
Providence Human Services of Wa

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

545 N Benjamin Ln
Ste 175
Boise, ID 83704
Phone (870) 949-9004

890 N Cole Rd
Ste B
Boise, ID 83704
Phone (208) 322-1026

7192 W Potomac Dr
Boise, ID 83704
Phone (208) 489-8311

545 N Benjamin Ln
Ste 185175
Boise, ID 83704

545 N Benjamin Ln
Ste 185
Boise, ID 83704
Phone (208) 322-1026

416 6th St
Wallace, ID 83873
Phone (208) 556-0960

Practitioners & affiliated clinicians

Practitioners 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1326466988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N BENJAMIN LN STE 185",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049625",
            "telephone_number": "208-322-1026",
            "fax_number": "208-322-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N BENJAMIN LN STE 185",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049625",
            "telephone_number": "208-322-1026",
            "fax_number": "208-322-1029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 10th Ave S",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836513832",
            "country_code": "US",
            "telephone_number": "208-466-2229",
            "fax_number": "208-466-2667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7192 W Potomac Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049147",
            "country_code": "US",
            "telephone_number": "833-527-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 S 16th St Ste 118",
            "address_purpose": "LOCATION",
            "city": "Payette",
            "state": "ID",
            "postal_code": "836613514",
            "country_code": "US",
            "telephone_number": "208-462-5079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1305 S Kimball Ave",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054542",
            "country_code": "US",
            "telephone_number": "208-459-1039",
            "fax_number": "208-459-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHWAYS OF IDAHO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-06-20",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "IDAHO STATE DIRECTOR",
        "authorized_official_telephone_number": "208-322-1026",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20004720",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ID_Inquiry@pathways.com",
            "affiliation": "N",
            "endpointDescription": "Email address to send questions, requests, etc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "545 N Benjamin Ln Ste 185",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837049625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.