Idagem Services Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

M9083 Issued in ID

Legal business name

IDAGEM SERVICES INC

Practice address

1533 N Milwaukee St
Ste 321
Boise, ID 83704-8471

Phone

(208) 283-6678

NPI assigned

Sep 28, 2009

Last updated

Oct 27, 2010By 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

Steven Krawtz

Title

Ceo

Phone

(208) 283-6678

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1831423557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 N MILWAUKEE ST",
            "address_2": "STE 321",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 N MILWAUKEE ST",
            "address_2": "STE 321",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048471",
            "telephone_number": "208-283-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAGEM SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "KRAWTZ",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-283-6678"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ID",
            "license": "M9083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Id Oms Specialty Dental Services, PLLC (Boise Oral Surgery & Implant Center)
• Id PHS LLC
• Id SDS II PLLC (Super Smiles Orthodontics)
• Idacare (IdaCare Inc.)
• Idacare Foundation
• Idaho Advanced Dental Anesthesia, LLC
• Idaho Advanced Medical Care LLC
• Idaho Anesthesia Professionals LLC
• Idaho Behavior Change
• Idaho Behavioral Health, Inc.

• Pulmonary Disease Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pulmonary Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.