Joanna Bork

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

D-288 Issued in ID

Practice address

100 E Idaho St
Suite 200
Boise, ID 83712-6267

Phone

(208) 381-7081

NPI assigned

Feb 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1740605740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 N GLEN ASPEN WAY",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695755",
            "telephone_number": "208-484-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126267",
            "telephone_number": "208-381-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORK",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "ID",
            "license": "D-288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Bordes, FNP-BC, APRN, MSN
• Danielle Bores, RD
• Elizabeth Borger
• Wendy Lee Borgerd, P.T.
• Michelle Borgquist, LMSW
• Nathaniel A Bork, DMD
• Alex Peter Bormann, M.D.
• Ian Borovatz, PHARM.D.
• Marlys Ann Borreson, L.C.P.C.
• Alicia R Borst, P.A.C.

• Pediatric Nutrition Registered Dietitian in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Nutrition Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.