Ada Plastic and Reconstructive Surgery

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

M7009 Issued in ID

Legal business name

ADA PLASTIC AND RECONSTRUCTIVE SURGERY

Practice address

900 N Liberty St
Suite 300
Boise, ID 83704-8704

Phone

(208) 367-6903

Fax

(208) 367-6904

NPI assigned

Apr 9, 2008

Last updated

Apr 11, 2008By 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

Mr. Thomas D McKim, M.D.

Title

Owning Physician

Phone

(208) 367-6901

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1548433790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST",
            "address_2": "SUITE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048704",
            "telephone_number": "208-367-6903",
            "fax_number": "208-367-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST",
            "address_2": "SUITE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048704",
            "telephone_number": "208-367-6903",
            "fax_number": "208-367-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA PLASTIC AND RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "MCKIM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNING PHYSICIAN",
        "authorized_official_telephone_number": "208-367-6901",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ID",
            "license": "M7009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ada County Treatment Services
• Ada Dermatology, P.a.
• Ada Home Health LLC
• Ada Orthopaedic Clinic
• Ada Pediatrics, P.a.
• Ada Surgical Associates, PA
• Ada Therapy Services PLLC
• Ada Vision Center East PLLC (Paul Bigelow OD)
• Ada Vision Center P.a.
• Adam Purcell LCSW PLLC

• Ambulatory Surgical Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.