Paul Kolodge

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

8620 W Emerald St Ste 150
Boise, ID 83704-4839

Phone

(208) 617-3265

NPI assigned

Nov 5, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1861361990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N SAGEHEN LN",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836515055",
            "telephone_number": "909-260-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8620 W EMERALD ST STE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044839",
            "telephone_number": "208-617-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODGE",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polina Kokoulina, PA-C
• Jason E Kolb, PA-C
• Peter H Kolb, DPT
• Lisa Margaret Kolesar, DPT, ACT/L
• Christopher L Koller, RPH
• Beau Alan Kolodzieczak, LPC
• Lindsay Kolpitcke
• Anuhya Kommalapati, MD
• Shane Kazuo Komoda, PHARM.D.
• Allyson J Komori, D.O.

• Community/Behavioral Health Agency in Boise, ID
• Providers in Boise, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.