NPIMap

Organization Active NPI

Southern Idaho Pain Institute P.C.

  • Ambulatory Surgical Clinic/Center
  • Twin Falls, ID
National Provider Identifier
1336240670
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
M7113 Issued in ID
Legal business name
SOUTHERN IDAHO PAIN INSTITUTE P.C.
Practice address
236 Martin St.
Twin Falls, ID 83301
Phone
(208) 733-3181
Fax
(208) 733-3168
NPI assigned
Sep 26, 2006
Last updated
Feb 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Clinton L. Dille, M.D.NPI 1306947569
Title
Owner/Anesthesiologist
Phone
(208) 733-3181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X M7113 ID Primary

Addresses

Primary practice location

236 Martin St.
Twin Falls, ID 83301

Mailing address

236 Martin St.
Twin Falls, ID 83301
Phone (208) 733-3181

Other identifiers 3

IdentifierTypeStateIssuer
03384OtherIDBLUE CROSS ASC#
000010006663OtherIDREGENCE ASC #
804229000MedicaidID

National Provider Directory

National Provider Directory

Locations

236 Martin St
Twin Falls, ID 83301
Phone (208) 733-3181

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16608/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GHDGBD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1336240670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MARTIN ST.",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 MARTIN ST.",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN IDAHO PAIN INSTITUTE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "DILLE",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "208-733-3181",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ID",
            "license": "M7113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ASC#",
            "identifier": "03384",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE ASC #",
            "identifier": "000010006663",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804229000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.