BOISE INTENSIVE CARE HOSPITAL INC (NPI# 1427293521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427293521 |
| Entity Type | Organization |
| Organization Name | BOISE INTENSIVE CARE HOSPITAL INC |
| Other Organization Name | COMPLEX CARE HOSPTIAL OF IDAHO |
| Practice Address |
2131 S Bonito Way Meridian ID 83642-1659 |
| Mailing Address |
5340 Legacy Dr Suite 150 Plano TX 75024-3178 |
| Practice Telephone | 8778012244 |
| Practice Fax Number | 2084899599 |
| Mailing Telephone | 4692412100 |
| Mailing Fax Number | 4692412177 |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2013-01-07 |
| Authorized Official Name | MR. JOHN MICHAEL CRONIN (VICE PRESIDENT) |
| Authorized Official Telephone | 4692412128 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | 69 | ID | Allopathic & Osteopathic Physicians |
| Y | 282E00000X | Long Term Care Hospital | 69 | ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE - B | 1369006 | 01 |
| ID | 808282500 | 05 |
| Other Name | Type Code |
|---|---|
| Complex Care Hosptial of Idaho | Doing Business As Name - Organization |
| Street Address |
2131 S BONITO WAY |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-1659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013986579 | Hampton Roads Medical Specialists PC | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2006-03-16 |
| 1003397878 | Hbs of Meridian, LLC | Psychiatric Hospital | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2018-08-28 |
| 1578915898 | Rc Dobrowolski PC | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2016-07-11 |
| 1487066320 | Matthew Johansen | Counselor | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2014-05-27 |
| 1932523164 | Owens Medical Pllc | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2014-02-07 |
| 1447502323 | Darian Robbins | Occupational Therapy Assistant | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2012-10-03 |
| 1952652083 | Elizabeth Rebecca Stuhr | Physical Therapist | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2012-09-28 |
| 1942551114 | Conrad William Estrem | Speech-Language Pathologist | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2012-09-27 |
| 1477679496 | Stephen Lloyd Green | Internal Medicine | 2131 S Bonito Way, Meridian, ID 83642-1659 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952303778 | Regency Hospital Company of Meridian, LLC | Long Term Care Hospital | 1102 Constitution Ave, 2nd Floor, Meridian, MS 39301-4001 | 2005-08-11 |
| 1003873225 | Rush Care, Inc. | Long Term Care Hospital | 1314 19th Ave, Meridian, MS 39301-4116 | 2006-05-01 |
| 1093772220 | Rush Care, Inc. | Long Term Care Hospital | 1314 19th Ave, Meridian, MS 39301-4116 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023079092 | Northern Idaho Advanced Care Hospital Inc | Long Term Care Hospital | 600 N Cecil Rd, Post Falls, ID 83854-6200 | 2006-03-30 |
| 1639514094 | Vibra Hospital of Boise LLC | Long Term Care Hospital | 6651 W Franklin Rd, Boise, ID 83709-0914 | 2013-04-30 |
| 1639211634 | St. Benedicts Family Medical Center | Long Term Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-02-13 |
| 1245371863 | St Lukes Regional Medical Center | Long Term Care Hospital | 895 N 6th E, Mtn Home, ID 83647-2207 | 2007-02-08 |
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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.