Vitanovu, P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

M-11233 Issued in ID

Legal business name

VITANOVU, P.C.

Practice address

1525 S Owyhee St
Boise, ID 83705-6014

Phone

(208) 344-8482

Fax

(208) 345-5426

NPI assigned

Sep 16, 2014

Last updated

Jan 26, 2016By 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

Jenifer Leah Barry, M.D.NPI 1164673968

Title

Director/Owner

Phone

(208) 344-8482

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jenifer L Barry, MD

  • Internal Medicine Physician
  • Boise, ID
  • NPI 1164673968
  Authorized official Same address or phone

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1821490335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 S OWYHEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056014",
            "telephone_number": "208-344-8482",
            "fax_number": "208-345-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 S OWYHEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056014",
            "telephone_number": "208-344-8482",
            "fax_number": "208-345-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITANOVU, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_middle_name": "LEAH",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "208-344-8482",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "M-11233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.