Pathways Neurofeedback Institute, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PATHWAYS NEUROFEEDBACK INSTITUTE, PLLC

Doing business as

Pathways Functional Medicine

Practice address

401 Brockman Loop
Jerome, ID 83338

Phone

(208) 734-1394

NPI assigned

Apr 28, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth Jo Johnson, MD

Title

Owner

Phone

(208) 734-1394

Specialties & licenses 1

Addresses

Other names 1

• Pathways Functional Medicine Doing business as

Locations

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1639867468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BROCKMAN LOOP",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "208-734-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BROCKMAN LOOP",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "208-734-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS NEUROFEEDBACK INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-734-1394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways Functional Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darlena Owens
• Samuel C Page, DMD
• Jeffrey Ryan Palmer, DDS
• Morgan B Parker, PHARM.D.
• Jennifer Parsons, NP-C
• Lizeth Moreno Peoble
• Amy S Peterson, IBCLC
• Stacey Michele Pound, M.S., CCC-SLP
• Gary Radford, PHARMD
• Jason Reading, PHARM-D

• Family Medicine Physician in Jerome, ID
• Providers in Jerome, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.