Organization Active NPI

River Run Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Boise, ID
National Provider Identifier
1881699874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RIVER RUN SURGERY CENTER, INC.
Practice address
727 E Riverpark LN
Ste 200
Boise, ID 83706-4097
Phone
(208) 433-8846
Fax
(208) 433-9854
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Boyajian, M.D.
Title
Medical Director
Phone
(208) 433-8846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

727 E Riverpark LN
Ste 200
Boise, ID 83706-4097

Mailing address

727 E Riverpark LN
Ste 200
Boise, ID 83706-4097
Phone (208) 433-8846

Other identifiers 1

IdentifierTypeStateIssuer
8061459MedicaidID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881699874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 E RIVERPARK LN",
            "address_2": "STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064097",
            "telephone_number": "208-433-8846",
            "fax_number": "208-433-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E RIVERPARK LN",
            "address_2": "STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064097",
            "telephone_number": "208-433-8846",
            "fax_number": "208-433-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RUN SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOYAJIAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "208-433-8846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8061459",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.