Imaging Center of Idaho, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

IMAGING CENTER OF IDAHO, LLC

Practice address

4519 Enterprise Way
Caldwell, ID 83605-8086

Phone

(208) 455-7482

Fax

(208) 455-7538

NPI assigned

Aug 22, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Gregory F. Clark

Title

Ceo

Phone

(208) 455-7482

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Diane R Newton, M.D.

  • Diagnostic Radiology Physician
  • Boise, ID
  • NPI 1689617797
  NPD (past)
• Paul D Traughber, M.D.

  • Diagnostic Radiology Physician
  • McCall, ID
  • NPI 1538107362
  NPD (past)

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1659528511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4813",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837114813",
            "telephone_number": "208-455-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 ENTERPRISE WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836058086",
            "telephone_number": "208-455-7482",
            "fax_number": "208-455-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING CENTER OF IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-455-7482",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idahodhwbh3 NP
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• Ideal Nursing Solutions LLC
• Ideal Option, PLLC
• Ideal Telemedicine Services LLC
• Imaging Center of Idaho, LLC
• Indian Creek Chiropractic PLLC
• Georgette Afya Ingabire
• Insight Consulting, Inc.
• Insight Optical

• Radiology Clinic/Center in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Radiology Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.