IDAHO FACIAL IMAGING LLC (NPI# 1437178399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437178399 |
| Entity Type | Organization |
| Organization Name | IDAHO FACIAL IMAGING LLC |
| Practice Address |
8119 Ustick Rd Suite 101 Boise ID 83704-5754 |
| Practice Telephone | 2085144740 |
| Practice Fax Number | 2083767012 |
| Mailing Telephone | 2085144740 |
| Mailing Fax Number | 2083767012 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRADEN M STAUTS (OWNER/PARTNER) |
| Authorized Official Telephone | 2085144740 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
4-D-2095 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE BLUE SHIELD-MEDIC | 000010156829 | 01 |
| ID | REGENCE BLUE SHIELD-DENTA | 000010156827 | 01 |
| Street Address |
8119 USTICK RD SUITE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-5754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881861581 | Robert Olson Jr. | Dentist | 8119 Ustick Rd, Boise, ID 83704-5754 | 2008-05-12 |
| 1003969288 | The Center for Sleep Apnea and Tmj Pa | Dentist | 8119 Ustick Rd, Boise, ID 83704-5754 | 2007-01-19 |
| 1285654848 | Jamison Ross Spencer | Dentist | 8119 Ustick Rd, Boise, ID 83704-5754 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629031760 | Swient, LLC | Clinic/Center | 900 N Liberty St, Suite 305, Boise, ID 83704-8704 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699175158 | Allied Imaging Inc | Clinic/Center | 2043 E Center St Ste 115, Pocatello, ID 83201-3300 | 2014-09-02 |
| 1982042693 | Alliance Healthcare Services Inc | Clinic/Center | 3581 E Overland Rd, Meridian, ID 83642-6757 | 2013-06-05 |
| 1316003726 | Advanced Open Imaging Boise LLC | Clinic/Center | 3581 East Overland Rd, Meridian, ID 83642 | 2006-12-29 |
| 1053305144 | Teton Mri of Idaho Falls | Clinic/Center | 2060 S Woodruff Ave, Idaho Falls, ID 83404-6396 | 2005-09-06 |
| 1982037107 | Sjrmc Interventional Radiology Services LLC | Clinic/Center | 415 6th St, Lewiston, ID 83501-2431 | 2013-08-12 |
| 1659528511 | Imaging Center of Idaho, LLC | Clinic/Center | 4519 Enterprise Way, Caldwell, ID 83605-8086 | 2008-08-22 |
| 1326230590 | Cassia Physicians Billing | Clinic/Center | 1501 Hiland Ave, Burley, ID 83318-2682 | 2007-08-13 |
| 1508991373 | Not-tsoo Gah-nee Indiane Health Services | Clinic/Center | Mission Road, Fort Hall, ID 83203 | 2007-02-22 |
| 1669483509 | Twin Falls Imaging and Diagnostic Center | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-08-09 |
| 1194798397 | Teton Open Mri of Pocatello, LLC | Clinic/Center | 246 N 18th Ave, Pocatello, ID 83201-3356 | 2006-02-08 |
| Find all providers with the same taxonomy | ||||
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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.