CENTER FOR PAIN CARE P A (NPI# 1023024684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023024684 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PAIN CARE P A |
| Practice Address |
115 W Main St Suite 102 Boise ID 83702-7302 |
| Practice Telephone | 2083424700 |
| Practice Fax Number | 2083424710 |
| Mailing Telephone | 2083424700 |
| Mailing Fax Number | 2083424710 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-19 |
| Authorized Official Name | DR. CLINTON MALLARI (ADMINISTRATOR) |
| Authorized Official Telephone | 2083424700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
115 W MAIN ST SUITE 102 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-7302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477941672 | Beacon Pain Clinic | Pain Medicine | 115 W Main St, 102, Boise, ID 83702-7302 | 2014-12-23 |
| 1477972768 | Holly Anne Piatt | Dietitian, Registered | 115 W Main St, Suite 203, Boise, ID 83702-7302 | 2014-04-15 |
| 1851591879 | Michelle Mae Freshwater | General Practice | 115 W Main St, Suite 101, Boise, ID 83702-7302 | 2007-07-18 |
| 1417971847 | Ambulatory Surgery Center of Boise | Clinic/Center | 115 W Main St, Suite 102, Boise, ID 83702-7302 | 2006-07-27 |
| 1154345585 | Clinton Mallari | Physical Medicine & Rehabilitation | 115 W Main St, Suite 102, Boise, ID 83702-7302 | 2006-07-27 |
| 1265452239 | Wilbur Allen Rader | General Practice | 115 W Main St, Suite 101, Boise, ID 83702-7302 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598305922 | Rebekah Guy | Physical Medicine & Rehabilitation | 115 W Main St Ste 201, Boise, ID 83702-7303 | 2020-01-14 |
| 1790825842 | Mark J Harris | Physical Medicine & Rehabilitation | 600 W Robbins Rd Ste 300, Boise, ID 83702-4568 | 2007-02-07 |
| 1609885870 | N S Support LLC | Physical Medicine & Rehabilitation | 6140 W Curtisian Ave, Suite 400, Boise, ID 83704 | 2006-08-06 |
| 1710995170 | Saint Alphonsus Physicians, Pa | Physical Medicine & Rehabilitation | 901 N Curtis Rd, Suite 304, Boise, ID 83706-1338 | 2006-08-03 |
| 1154345585 | Clinton Mallari | Physical Medicine & Rehabilitation | 115 W Main St, Suite 102, Boise, ID 83702-7302 | 2006-07-27 |
| 1356377535 | Daniel Richard Marsh | Physical Medicine & Rehabilitation | 8950 W Emerald St, Ste 168, Boise, ID 83704-8296 | 2006-06-23 |
| 1497711329 | Idaho Physical Medicine and Rehabilitation Pa | Physical Medicine & Rehabilitation | 600 Robbins Rd, Suite #300, Boise, ID 83702-4539 | 2006-04-20 |
| 1093791972 | Barbara E Quattrone | Physical Medicine & Rehabilitation | 600 Robbins Rd, Suite 300, Boise, ID 83702-4565 | 2005-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417267329 | Idaho Pain Clinic Pllc | Physical Medicine & Rehabilitation | 1327 Superior St Ste 101, Sandpoint, ID 83864-2742 | 2010-10-13 |
| 1497949705 | Idaho Physical Medicine and Rehabilitation Pa | Physical Medicine & Rehabilitation | 3551 E Overland Road, Meridian, ID 83642 | 2007-08-29 |
| 1427151539 | Beth S Rogers | Physical Medicine & Rehabilitation | 360 E Montvue Dr Ste 100, Meridian, ID 83642-6318 | 2006-09-06 |
| 1386887032 | Michael Bryon Spackman | Physical Medicine & Rehabilitation | 360 E Montvue Dr, Suite 100, Meridian, ID 83642 | 2009-04-10 |
| 1396945069 | James H Morland, Md | Physical Medicine & Rehabilitation | 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 | 2007-07-20 |
| 1780769075 | Kevin S Hill | Physical Medicine & Rehabilitation | 777 Hospital Way, Suite G15, Pocatello, ID 83201-5175 | 2006-10-26 |
| 1215975164 | James H Morland | Physical Medicine & Rehabilitation | 3875 E Overland Rd, Suite 200, Meridian, ID 83642-9005 | 2006-06-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.