NPIMap

Organization Active NPI

Boundary Medicine & Wellness, LLC

  • Internal Medicine Physician
  • Moyie Springs, ID
National Provider Identifier
1437866654
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BOUNDARY MEDICINE & WELLNESS, LLC
Practice address
7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187
Phone
(208) 304-6401
NPI assigned
Oct 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Christopher Maynard Bryant, DO
Title
Owner
Phone
(208) 304-6401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X

Addresses

Primary practice location

7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187

Mailing address

7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187
Phone (208) 304-6401

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1437866654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 OLD HIGHWAY TWO LOOP",
            "city": "MOYIE SPRINGS",
            "state": "ID",
            "postal_code": "838455187",
            "telephone_number": "208-304-6401",
            "fax_number": "208-684-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 OLD HIGHWAY TWO LOOP",
            "city": "MOYIE SPRINGS",
            "state": "ID",
            "postal_code": "838455187",
            "telephone_number": "208-304-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDARY MEDICINE & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-28",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MAYNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-304-6401",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moyie Springs, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.