Idaho Sleep and Wellness LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

D-3565 Issued in ID

Legal business name

IDAHO SLEEP AND WELLNESS LLC

Practice address

1500 W Cayuse Creek Dr Ste 100
Meridian, ID 83646-4757

Phone

(208) 899-2384

NPI assigned

Jun 19, 2018

Last updated

Jun 19, 2018By 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

Dr. Matthew L Kooyman, DDSNPI 1699782854

Title

Owner

Phone

(208) 899-2384

Specialties & licenses 2

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.

• Matthew L Kooyman, DDS

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1699782854
  Authorized official Same address or phone

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1477047926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W CAYUSE CREEK DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464757",
            "telephone_number": "208-888-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W CAYUSE CREEK DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464757",
            "telephone_number": "208-899-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO SLEEP AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "KOOYMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-899-2384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3565",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ID",
            "license": "D-3565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Otologic Surgery Center, LLC (Syringa Outpatient Surgery Center)
• Idaho Pediatric Speech and Language, LLC
• Idaho Pediatric Therapy Clinic PLLC
• Idaho Physical Medicine and Rehabilitation PA
• Idaho Physical Medicine and Rehabilitation PA
• Idaho Spine & Pain PLLC
• Idaho Spine and Sports Physical Therapy - Silverstone
• Idaho Sports Bracing Inc
• Idaho State University (ISU Meridian Counseling Clinic)
• Idaho State University

• Customized Equipment (DME) in Meridian, ID
• Providers in Meridian, ID by specialty
• Customized Equipment (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.