Active NPI
Mark a Spelich MD PC
- Orthopaedic Surgery Physician
- Boise, ID
National Provider Identifier
1346375417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- M9278
- Legal business name
- MARK A SPELICH MD PC
- Practice address
- 6590 W Norwood Dr
Boise, ID 83704 - Phone
- (208) 855-2410
- Fax
- (208) 855-0157
- NPI assigned
- Feb 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lori J Sarich
- Title
- Office Manager
- Phone
- (208) 855-2410
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | M9278 | ID | Primary |
Addresses
Primary practice location
6590 W Norwood Dr
Boise, ID 83704
Mailing address
6590 W Norwood Dr
Boise, ID 83704
Phone (208) 855-2410
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74880 | Other | ID | BLUE CROSS OF IDAHO # |
| 807210200 | Medicaid | ID | |
| 000010151179 | Other | ID | REGENCE BLUE SHIELD # |
National Provider Directory
National Provider DirectoryMember organizations 5
Organizations listed as members of this organization in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210204800000",
"number": "1346375417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6590 W NORWOOD DR",
"city": "BOISE",
"state": "ID",
"postal_code": "83704",
"telephone_number": "208-855-2410",
"fax_number": "208-855-0157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6590 W NORWOOD DR",
"city": "BOISE",
"state": "ID",
"postal_code": "83704",
"telephone_number": "208-855-2410",
"fax_number": "208-855-0157"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARK A SPELICH MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-22",
"last_updated": "2008-05-08",
"status": "A",
"authorized_official_last_name": "SARICH",
"authorized_official_first_name": "LORI",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "208-855-2410",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "ID",
"license": "M9278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO #",
"identifier": "74880",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807210200",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD #",
"identifier": "000010151179",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}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 May 8, 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.