Wind River Pain Management PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WIND RIVER PAIN MANAGEMENT PLLC

Practice address

1975 Martha Ave
Suite B
Idaho Falls, ID 83404-7580

Phone

(208) 522-4598

Fax

(208) 529-3915

NPI assigned

Jul 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Steven V Klippert, MD

Title

Owner

Phone

(208) 522-4598

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Craig Stephen Kantack, PA-C

  • Medical Physician Assistant
  • Idaho Falls, ID
  • NPI 1699052357
  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1669785192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVE",
            "address_2": "SUITE B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047580",
            "telephone_number": "208-522-4598",
            "fax_number": "208-529-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MARTHA AVE",
            "address_2": "SUITE B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047580",
            "telephone_number": "208-522-4598",
            "fax_number": "208-529-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIND RIVER PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "KLIPPERT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-522-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Millie Wilson
• Nichole Chauntelle Wilson
• William P.D. Wilson III, M.D.
• Angela Winchester
• David Winchester, FNP
• Drue Marie Winder, FNP
• Natalie Winegar
• Shayle Wines
• Eric A Wingerson, D.O.
• Ashley Elizabeth Winward, COTA

• Pain Medicine (Anesthesiology) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Pain Medicine (Anesthesiology) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.