Idaho Advanced Imaging PA
Radiology, Diagnostic Radiology in Nampa, ID. Organization (NPI-2).
NPI number1649335373
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1649335373
- Entity type
- Organization (NPI-2)
- Legal business name
- Idaho Advanced Imaging PA
- Organization subpart
- No
- Enumeration date
- Dec 22, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | – | – | Yes |
Practice location
1512 12th Ave RdNampa, ID 83686-6008
Phone 208-463-5431
Mailing address
Po Box 9649Boise, ID 83707-4649
Phone 208-472-8121 · Fax 208-472-8172
Authorized official
Janice W Brooks
Owner
2084635431
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