Pain Specialists of Idaho

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

SPHY11061 Issued in ID

Legal business name

PAIN SPECIALISTS OF IDAHO

Practice address

2375 E Sunnyside Rd Ste J
Idaho Falls, ID 83404-8281

Phone

(208) 522-7246

Fax

(208) 529-2620

NPI assigned

Mar 12, 2012

Organization subpart

No

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

Authorized official

Name

Cori D Anderson

Title

Billing Manager

Phone

(208) 522-7246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1992070809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE J",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-522-7246",
            "fax_number": "208-529-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE J",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-522-7246",
            "fax_number": "208-529-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN SPECIALISTS OF IDAHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CORI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-522-7246"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "ID",
            "license": "SPHY11061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Padron, CADC
• Merrill Page
• Michaelina S Page, RN
• Casondra Dawn Pahis, DPT
• Pain Specialists of Idaho
• Sandy Palma
• Emily Lou Palmer, M.S. CCC-SLP
• Jill Palmer, MFT
• Kathleen Palmer, LMSW
• Mathew Greg Palmer, DDS

• Pain Medicine (Anesthesiology) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Pain Medicine (Anesthesiology) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.