Idaho Eye Pros of Boise

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

IDAHO EYE PROS OF BOISE

Practice address

291 N Milwaukee St
Suite A3
Boise, ID 83704-9132

Phone

(208) 297-7019

Fax

(208) 375-7970

NPI assigned

Apr 15, 2014

Last updated

Apr 15, 2014By 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

Lavar W Kofoed, ODNPI 1023231420

Title

Owner

Phone

(208) 378-7020

Specialties & licenses 1

Addresses

Locations

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.

• Lavar W Kofoed, O.D.

  • Optometrist
  • Boise, ID
  • NPI 1023231420
  Authorized official Same address or phone

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1427477793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 N MILWAUKEE ST",
            "address_2": "SUITE A3",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049132",
            "telephone_number": "208-297-7019",
            "fax_number": "208-375-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 N MILWAUKEE ST",
            "address_2": "SUITE A3",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049132",
            "telephone_number": "208-297-7019",
            "fax_number": "208-375-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO EYE PROS OF BOISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "KOFOED",
        "authorized_official_first_name": "LAVAR",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-378-7020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Eating and Body Institute
• Idaho Endocrinology, PLLC
• Idaho Endodontics
• Idaho Endodontics PA (Herbert R Blaser DDS PA)
• Idaho Endoscopy Center LLC
• Idaho Eyecare Center
• Idaho Eyelid & Facial Plastic Surgery , PLLC
• Idaho Face & Voice, LLC
• Idaho Facial Imaging LLC
• Idaho Family Dental PLLC

• Optometrist in Boise, ID
• Providers in Boise, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.