NPIMap

Organization Active NPI

Craniofacial Pain Center of Idaho

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
National Provider Identifier
1902144561
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CRANIOFACIAL PAIN CENTER OF IDAHO
Practice address
3400 La Touche St.
Anchorage, AK 99508-4208
Phone
(208) 376-3600
Fax
(208) 376-3616
NPI assigned
Jan 16, 2013
Last updated
Aug 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Authorized official

Name
Rose Mary Milner
Title
VP of Operations
Phone
(208) 376-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

3400 La Touche St.
Anchorage, AK 99508-4208

Mailing address

8119 W Ustick Rd
Boise, ID 83704-5754
Phone (208) 376-3600

National Provider Directory

National Provider Directory
Tax ID family
Center for Sleep Apnea2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1902144561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8119 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045754",
            "telephone_number": "208-376-3600",
            "fax_number": "208-376-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LA TOUCHE ST.",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084208",
            "telephone_number": "208-376-3600",
            "fax_number": "208-376-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANIOFACIAL PAIN CENTER OF IDAHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "MILNER",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "208-376-3600"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.