Vision Quest Medical Center, PA

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VISION QUEST MEDICAL CENTER, PA

Practice address

5680 W Gage St
Boise, ID 83706-1326

Phone

(208) 377-3937

Fax

(208) 377-9455

NPI assigned

May 1, 2006

Organization subpart

No

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

Authorized official

Name

Jacob A Mong, DO

Title

President

Phone

(208) 377-3937

Specialties & licenses 2

Addresses

Other identifiers 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vision Quest Medical Center, PA

  • Ophthalmology Physician
  • Meridian, ID
  • NPI 1568664506

  Member Of

  NPD member

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1780641902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061326",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061326",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 W Cherry Ln Ste 207",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428530",
            "country_code": "US",
            "telephone_number": "208-898-1614",
            "fax_number": "208-898-1618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2720 W Cherry Ln",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421137",
            "country_code": "US",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION QUEST MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "MONG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-377-3937",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807072200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807072300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Virgen
• Virtual Radiology Associates LLC
• Vision One Inc (Vision One)
• Vision Quest Medical Center, PA
• Vision Quest Medical Center, PA
• Vision Quest Medical Center, PA
• Visions Counseling & Education, LLC
• Visionworks, Inc. (Visionworks)
• Juliann C Visser, PA-C
• Vista Chiropractic

• Durable Medical Equipment & Medical Supplies in Boise, ID
• Providers in Boise, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.