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

Idaho Sports & Spine PLLC

Organization Sports Medicine (Family Medicine) Physician · NPI 1033417035

Idaho Sports & Spine PLLC is a Sports Medicine (Family Medicine) Physician in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

950 Hospital Way Ste A
Pocatello, ID 83201-2789
Phone: (208) 478-4522
Fax: (208) 478-2935
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence O-0400 (ID)

Record details

NPI number1033417035
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Hansen — Owner · (208) 478-4522
Other names Christopher R Johnson Do, Pllc
NPI enumeratedMarch 1, 2011
Last updated in NPPESNovember 4, 2019
Mailing address950 Hospital Way, Ste A, Pocatello, ID 83201-2789

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