EAST IDAHO ORTHOPAEDICS, PLLC (NPI# 1144413154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144413154 |
| Entity Type | Organization |
| Organization Name | EAST IDAHO ORTHOPAEDICS, PLLC |
| Other Organization Name | LILJENQUIST & REDD ORTHOPEDIC SURGERY |
| Practice Address |
3405 Merlin Drive Idaho Falls ID 83404 |
| Mailing Address |
3405 Merlin Dr Idaho Falls ID 83404-7430 |
| Practice Telephone | 2085223355 |
| Practice Fax Number | 2085226019 |
| Mailing Telephone | 2085223355 |
| Mailing Fax Number | 2085226019 |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2016-05-05 |
| Authorized Official Name | JOSEPH R LILJENQUIST (PRESIDENT) |
| Authorized Official Telephone | 2085223355 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | M-10197 | ID | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
M9781 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807709400 | 05 |
| Other Name | Type Code |
|---|---|
| Liljenquist & Redd Orthopedic Surgery | Doing Business As Name - Organization |
| Street Address |
3405 MERLIN DRIVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558375568 | Joseph R Liljenquist | Orthopaedic Surgery | 3405 Merlin Drive, Idaho Falls, ID 83404 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558375568 | Joseph R Liljenquist | Orthopaedic Surgery | 3405 Merlin Drive, Idaho Falls, ID 83404 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399517 | Delaney Bergen | Orthopaedic Surgery | 738 N College Rd Ste C, Twin Falls, ID 83301-3387 | 2020-08-31 |
| 1164597431 | Douglas Alan Cipriano | Orthopaedic Surgery | 606 N. 3rd Avenue, Suite 201, Sandpoint, ID 83864-1689 | 2006-11-22 |
| 1124061163 | Sun Valley Sports Medicine, P.a. | Orthopaedic Surgery | 191 5th St W, Ketchum, ID 83340 | 2006-06-14 |
| 1568443158 | Paul Calvin Collins | Orthopaedic Surgery | 3875 E Overland Rd, Meridian, ID 83642-9005 | 2005-11-10 |
| 1063418903 | George A. Wade | Orthopaedic Surgery | 1188 University Dr, Boise, ID 83706-3009 | 2005-06-24 |
| 1306842182 | Michael J Gustavel | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2005-06-24 |
| 1861961732 | Gustavel Orthopedics Pllc | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2018-11-20 |
| 1114445087 | Bmh Inc. | Orthopaedic Surgery | 560 Memorial Dr, Pocatello, ID 83201-4070 | 2017-08-31 |
| 1982060984 | Bonner General Hospital, Inc | Orthopaedic Surgery | 606 N 3rd Ave, Ste 201, Sandpoint, ID 83864-1594 | 2016-01-06 |
| 1477965952 | Gregory M. Ford, Md Pllc | Orthopaedic Surgery | 950 Hospital Way, Ste A, Pocatello, ID 83201-2789 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.