Idaho Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IDAHO SURGERY CENTER, LLC

Practice address

3115 Medical Drive
Caldwell, ID 83605-6972

Phone

(208) 453-8668

Fax

(208) 453-8448

NPI assigned

Jan 23, 2006

Last updated

Aug 31, 2011By 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

Kathy Hogue

Title

Business Office Manager

Phone

(208) 453-8668

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Idaho Surgery Center Other name

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1386614519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 MEDICAL DRIVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056972",
            "telephone_number": "208-453-8668",
            "fax_number": "208-453-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 MEDICAL DRIVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056972",
            "telephone_number": "208-453-8668",
            "fax_number": "208-453-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "HOGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "208-453-8668"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807417200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Idaho Sleep and Neurology, PLLC
• Idahodhwbh3 Cald Amh PSR
• Idahodhwbh3 Caldwell CMH PSR
• Idahodhwbh3 Case Management
• Idahodhwbh3 Midlevel Group
• Idahodhwbh3 NP

• Ambulatory Surgical Clinic/Center in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.