NPIMap

Organization Active NPI

Pain Center Inc

  • Pain Clinic/Center
  • Boise, ID
National Provider Identifier
1740582303
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
M5883 Issued in ID
Legal business name
PAIN CENTER INC
Practice address
633 N 4TH St
Boise, ID 83702-4510
Phone
(208) 342-9800
Fax
(208) 342-4223
NPI assigned
Dec 2, 2010
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Dr. Sandra A Thompson, M.D.NPI 1326085713
Title
Owner
Phone
(208) 342-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X M5883 ID Primary
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

633 N 4TH St
Boise, ID 83702-4510

Mailing address

633 N 4TH St
Boise, ID 83702-4510
Phone (208) 342-9800

Other practice location 1

1825 S Kimball Avenue
Caldwell, ID 83605-4510
Phone (208) 455-3535

Other identifiers 1

IdentifierTypeStateIssuer
004277900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110124001272 ID Part B Supplier - Clinic/Group Practice 0941489819 Receives reassigned benefits from 7 practitioners
Practice locations: Boise, ID; Caldwell, ID
O20200825002174 ID DME Supplier - Physician - Interventional Pain Management 0941489819 Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

633 N 4th St
Boise, ID 83702
Phone (208) 342-9800

701 N College Rd Ste a
Twin Falls, ID 93301
Phone (208) 342-9800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13461/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1740582303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N 4TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024510",
            "telephone_number": "208-342-9800",
            "fax_number": "208-342-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N 4TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024510",
            "telephone_number": "208-342-9800",
            "fax_number": "208-342-4223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 S Kimball Avenue",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054510",
            "country_code": "US",
            "telephone_number": "208-455-3535",
            "fax_number": "208-455-5190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-342-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "ID",
            "license": "M5883",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004277900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.