Childrens Kidney Specialists PLLC

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

M6943 Issued in ID

Legal business name

CHILDRENS KIDNEY SPECIALISTS PLLC

Practice address

100 E Idaho St
200
Boise, ID 83712-6223

Phone

(208) 381-7336

Fax

(208) 381-7495

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Randall Jenkins, MD

Title

Doctor

Phone

(208) 381-7336

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1700088002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 NW NORFOLK CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298448",
            "telephone_number": "503-297-3178",
            "fax_number": "208-381-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "address_2": "200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126223",
            "telephone_number": "208-381-7336",
            "fax_number": "208-381-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS KIDNEY SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "208-381-7336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "ID",
            "license": "M6943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010026970",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003401500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children'S Home Society of Idaho
• Children'S Home Society of Idaho
• Children'S Therapy Place, Inc.
• Children'S Therapy Place, Inc.
• Children'S Therapy Place, Inc.
• Denise Childs
• Michelle Lee Chin, ARNP
• Elva Chinabalire
• Elvine Angeline Chinabalire
• Chinese Acupuncture & Natural Therapy Center

• Pediatric Nephrology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Nephrology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.