Q17 Health Partners LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

Q17 HEALTH PARTNERS LLC

Practice address

100 East Idaho Street #317
Boise, ID 83712

Phone

(208) 433-1736

Fax

(208) 433-1738

NPI assigned

Oct 11, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Russell H Griffiths, MD

Title

President

Phone

(208) 433-1736

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1427523968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST IDAHO STREET #317",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-433-1736",
            "fax_number": "208-433-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAST IDAHO STREET #317",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-433-1736",
            "fax_number": "208-433-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Q17 HEALTH PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "GRIFFITHS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-433-1736",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805132700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Purnell, MS, LPC, NCC
• Marybeth Puzio, CRNA
• Nicole F Pyle, PA-C
• Stephen Pyper
• Melissa Marie Pysnak, DDS
• Huiling Qi, M.D.
• Quality Care Counseling Center Inc.
• Quality Family Dentistry
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• Amy L Quam, LMSW

• Plastic and Reconstructive Surgery Physician in Boise, ID
• Providers in Boise, ID by specialty
• Plastic and Reconstructive Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.