Phoenix Health LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PHOENIX HEALTH LLC

Doing business as

PIBCOA-The Pain, Injury and Brain Centers of America

Practice address

3142 W Belltower Dr
Meridian, ID 83646-4882

Phone

(208) 996-0099

NPI assigned

Aug 26, 2020

Last updated

Aug 26, 2020By 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

Katie Jones, RNNPI 1447872502

Title

Owner/Clinician

Phone

(208) 996-0099

Specialties & licenses 1

Addresses

Other names 1

• PIBCOA-The Pain, Injury and Brain Centers of America Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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.

• Katie Lee Jones, RN

  • Registered Nurse
  • Meridian, ID
  • NPI 1447872502
  NPD Authorized official

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1942813134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 W BELLTOWER DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464882",
            "telephone_number": "208-996-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 W BELLTOWER DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464882",
            "telephone_number": "208-996-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "208-996-0099",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "3142 W Belltower Dr",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836464882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PIBCOA-The Pain, Injury and Brain Centers of America",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Pain Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.