Ada Pediatrics, P.a.
Organization Active NPI Pediatrics Physician · Boise, ID
NPI 1609805779 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1609805779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- ADA PEDIATRICS, P.A.
- Practice address
- 650 N Cole Rd
Boise, ID 83704-9117 - Phone
- (208) 323-1222
- Fax
- (208) 323-1825
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert E Lindsay, M.D.
- Title
- Owner
- Phone
- (208) 323-1222
Practitioners 2
-
Jenna Lindsay Gere, PNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0521701 | Ada Pediatrics PA | Certificate of waiver | May 31, 2028 |
National Provider Directory
Locations
650 N Cole Rd
Boise, ID 83704
Phone (208) 323-1222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
650 N Cole Rd
Boise, ID 83704-9117
Mailing address
650 N Cole Rd
Boise, ID 83704-9117
Phone (208) 323-1222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010006736 | Other | REGENCE BS OF IDAHO | |
| 86611 | Other | BLUE CROSS OF IDAHO |
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.