Organization Active NPI

Direct Orthopedic Care LLC

  • Orthopaedic Surgery Physician
  • Nampa, ID
National Provider Identifier
1932640851
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DIRECT ORTHOPEDIC CARE LLC
Practice address
16818 N Marketplace Blvd
Nampa, ID 83687-5140
Phone
(208) 321-4000
Fax
(208) 855-0157
NPI assigned
Mar 10, 2017
Last updated
Mar 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Authorized official

Name
Jenny Hamilton
Title
Billing Office Manager
Phone
(208) 321-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

16818 N Marketplace Blvd
Nampa, ID 83687-5140

Mailing address

7979 W Rifleman St
Boise, ID 83704-9066
Phone (208) 321-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170721001998 ID DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2163648155 Practice locations: Nampa, ID

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Direct Orthopedic Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1932640851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7979 W RIFLEMAN ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049066",
            "telephone_number": "208-321-4000",
            "fax_number": "208-855-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16818 N MARKETPLACE BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875140",
            "telephone_number": "208-321-4000",
            "fax_number": "208-855-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT ORTHOPEDIC CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGER",
        "authorized_official_telephone_number": "208-321-4000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.