Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idaho Physical Medicine and Rehabilitation PA

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1497949705

Idaho Physical Medicine and Rehabilitation PA is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3551 E Overland Rd
Meridian, ID 83642
Phone: (208) 884-1333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X (ID)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X

Record details

NPI number1497949705
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationIdaho Physicial Medicine and Rehabilitation
Authorized official Kate Shelton — Administrator · (208) 287-6558
NPI enumeratedAugust 29, 2007
Last updated in NPPESJune 5, 2014
Mailing addressPo Box 1128, Boise, ID 83701-1128

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