Active NPI
Philip David Rainey, OD
- Optometrist
- Boise, ID
National Provider Identifier
1437346483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP 100143
- Practice address
- 2051 S Cole Rd
Boise, ID 83709-2815 - Phone
- (208) 672-1200
- NPI assigned
- Oct 3, 2007
- Last updated
- Jan 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP 100143 | ID | Primary |
Addresses
Primary practice location
2051 S Cole Rd
Boise, ID 83709-2815
Mailing address
679 N Dunbarton PL
Star, ID 83669-5681
Phone (208) 514-6405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0799974 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP 100143 | ID | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1437346483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "679 N DUNBARTON PL",
"city": "STAR",
"state": "ID",
"postal_code": "836695681",
"telephone_number": "208-514-6405",
"fax_number": "208-955-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 S COLE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837092815",
"telephone_number": "208-672-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINEY",
"first_name": "PHILIP",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-03",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP 100143",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0799974",
"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 Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.