Idaho Neurology PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

M11896 Issued in ID

Legal business name

IDAHO NEUROLOGY PLLC

Practice address

901 N Curtis Rd
Suite 101
Boise, ID 83706-1338

Phone

(208) 608-5825

Fax

(208) 287-3690

NPI assigned

May 8, 2013

Last updated

Jun 5, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas Swanson, MD

Title

Owner

Phone

(406) 274-2295

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1720423429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD STE 121",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD",
            "address_2": "SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061338",
            "telephone_number": "208-608-5825",
            "fax_number": "208-287-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-274-2295",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "M11896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Neurology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.