Central Idaho Infusion Center LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

CENTRAL IDAHO INFUSION CENTER LLC

Practice address

868 E Main St
Jerome, ID 83338-2446

Phone

(208) 316-6424

NPI assigned

Feb 26, 2024

Organization subpart

No

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

Authorized official

Name

Jolyne Dickinson, RN

Title

Office Manager

Phone

(208) 316-6424

Specialties & licenses 1

Addresses

Other names 1

• Central Idaho Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul A Dickinson, CRNA

  • Certified Registered Nurse Anesthetist
  • Jerome, ID
  • NPI 1912137175
  Medicare reassignment NPD

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1962268938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 8TH AVE E",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833382139",
            "telephone_number": "208-316-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 E MAIN ST",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833382446",
            "telephone_number": "208-316-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IDAHO INFUSION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "JOLYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-316-6424",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Idaho Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Paige Braga, LCSW
• Clarence Jaron Brunson, MD
• Jasmine Brooke Brunson, M.S., CFY-SLP
• Demsie M Butler, MD
• Trey K Carter
• Michelle Clark, RTT PRACTITIONER
• Austin Cobbley, DPT
• Communicare, Inc
• Communicare, Inc
• Counties of Jerome Lincoln

• Health Service Clinic/Center in Jerome, ID
• Providers in Jerome, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.