Richard Alan Dubose, MD

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

M7865 Issued in ID

Practice address

600 N Robbins Rd
Suite 300
Boise, ID 83702-4565

Phone

(208) 489-4016

Fax

(208) 489-4015

NPI assigned

Dec 5, 2006

Last updated

Jan 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Idaho Pain Medicine, LLP

  • Interventional Pain Medicine Physician
  • Boise, ID
  • NPI 1588832992
  NPD (past)
• Idaho Physical Medicine and Rehabilitation PA

  • Ambulatory Surgical Clinic/Center
  • Meridian, ID
  • NPI 1497949705
  NPD (past)
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

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

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1659922201
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1821156365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837011128",
            "telephone_number": "208-489-4016",
            "fax_number": "208-489-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ROBBINS RD",
            "address_2": "SUITE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024565",
            "telephone_number": "208-489-4016",
            "fax_number": "208-489-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "ID",
            "license": "M7865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR AND IND",
            "identifier": "185570800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "57430",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821156365",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010005570",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drugshield Inc
• Robert John Dry, D.C.
• DTG II PLLC (BeyondMD)
• Matthew Saul Dubman, APRN-CNP
• Kittrick Randall Duboise, CRNA
• Felica Jo Duce, LCPC
• Kody Michael Duclos, RD, LD
• Casey Dudek
• John Kenneth Dudek, M.D.
• Dudley Chiropractic P.a.

• Pain Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pain Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.