Sipi Clinic LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SIPI CLINIC LLC

Doing business as

Southern Idaho Pain Institute

Practice address

176 Falls Ave
Twin Falls, ID 83301-2306

Phone

(208) 733-3181

Fax

(208) 733-3168

NPI assigned

Jan 6, 2023

Last updated

May 6, 2024By 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

Denise Rue

Title

Office Manager

Phone

(208) 733-3181

Specialties & licenses 2

Addresses

Other names 1

• Southern Idaho Pain Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 6

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.

• Clinton L. Dille, M.D.

  • Anesthesiology Physician
  • Twin Falls, ID
  • NPI 1306947569

  Specialist

  Medicare reassignment Care Compare group NPD
• Tyler Roe, DO

  • Pain Medicine (Anesthesiology) Physician
  • Burley, ID
  • NPI 1710305768
  Medicare reassignment Care Compare group NPD
• Michael R McEntire, MD

  • Pain Medicine (Anesthesiology) Physician
  • Rochester, MN
  • NPI 1477875094

  ID

  Medicare reassignment Care Compare group NPD
• Benjamin W Attebury, PA-C

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1437345923
  Medicare reassignment Care Compare group
• John Laurent Etcheto, PA

  • Physician Assistant
  • Twin Falls, ID
  • NPI 1073547113
  Medicare reassignment Care Compare group
• John Urrutia, P.A.C

  • Medical Physician Assistant
  • Twin Falls, ID
  • NPI 1831290097
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1780398586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833012306",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833012306",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIPI CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "RUE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-733-3181"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Idaho Pain Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Idaho Pain Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mason D Simkins, PA-C
• Drew Bradley Simmons, NP
• Kate Simonds, COUI
• Sipi Ambulatory Surgery Center
• Sipi ASC LLC (Sipi Ambulatory Surgery Center)
• Jillian Marjorie Sirucek Adepoju, D.C.
• Anthony James Sirucek, D.C.
• Amanda Elizabeth Sisneros, MS CCC-SLP
• Sitman, Inc.
• Randall J Skeem

• Specialist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.