Organization Active NPI

Alliance Medical Group, LLC

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1487326203
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLIANCE MEDICAL GROUP, LLC
Practice address
7350 W Victory Rd
Boise, ID 83709-4237
Phone
(208) 809-2888
Fax
(208) 809-2889
NPI assigned
Sep 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Linda Barnes
Title
Credentialing MGR
Phone
(208) 985-1423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7350 W Victory Rd
Boise, ID 83709-4237

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Other names 1

  • Primary Health Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050512000561 ID Part B Supplier - Clinic/Group Practice 3971544685 Receives reassigned benefits from 135 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Garden City, ID; Kuna, ID; Meridian, ID; Nampa, ID; Eagle, ID; Boise, ID; Caldwell, ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2240160Primary Health Medical Group - Victory & Cole7350 W Victory Rd, Boise, ID 83709Provider-performed microscopyOct 17, 2027

National Provider Directory

National Provider Directory

Locations

8456 W Emerald Ste 156
Boise, ID 83704
Phone (208) 947-1947

6348 W Emerald St
Boise, ID 83704
Phone (208) 302-0900

1209 S Broadway Ave
Boise, ID 83706
Phone (208) 345-1222

300 W Myrtle St
Ste 100
Boise, ID 83702
Phone (208) 472-9082

4971 W Overland Rd
Boise, ID 83705
Phone (208) 472-5050

10787 W Ustick Rd
Boise, ID 83713
Phone (208) 378-8011

435 S Eagle Rd
Ste 100
Eagle, ID 83616
Phone (208) 609-9130

1895 McGrath Rd
Eagle, ID 83616
Phone (208) 939-8200

435 S Eagle Rd
Eagle, ID 83616
Phone (208) 939-8200

1474 N Meridian Rd
Kuna, ID 83634
Phone (208) 809-2885

1900 W Chinden Blvd
Meridian, ID 83646
Phone (208) 809-2860

3280 E Lanark Dr
Meridian, ID 83642
Phone (208) 377-4400

1375 N Happy Valley Rd
Nampa, ID 83687
Phone (208) 809-2869

Practitioners & affiliated clinicians

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1487326203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 W VICTORY RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837094237",
            "telephone_number": "208-809-2888",
            "fax_number": "208-809-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "208-985-1423"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.