Intermountain Eye and Laser Centers PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

INTERMOUNTAIN EYE AND LASER CENTERS PLLC

Practice address

3090 E Gentry Way Ste 120
Meridian, ID 83642-3549

Phone

(208) 888-0005

NPI assigned

Jun 22, 2023

Organization subpart

Yes

Parent organization

INTERMOUNTAIN EYE AND LASER CENTERS PLLCAs reported in NPPES

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

Authorized official

Name

Brent S Betts, MD

Title

Partner

Phone

(801) 581-2352

Specialties & licenses 4

Addresses

Other names 1

• INTERMOUNTAIN EYE CENTERS Doing business as

Part of

Fishburn Joh R MD

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Intermountain Eye and Laser Centers PLLC

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1730119611
  NPPES parent name

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1679259097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N CURTIS RD STE 205",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061316",
            "telephone_number": "208-373-1200",
            "fax_number": "208-373-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 E GENTRY WAY STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423549",
            "telephone_number": "208-888-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN EYE AND LASER CENTERS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN EYE AND LASER CENTERS PLLC",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "BETTS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-581-2352",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTERMOUNTAIN EYE CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Meridian, ID
• Ophthalmology Physician in Idaho

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