1. Home
  2. Directory
  3. Idaho
  4. Burley
  5. Anesthesiology
  6. NPI Profile

MAGIC VALLEY PAIN SPECIALISTS, PLLC
NPI 1003564998
Anesthesiology - Pain Medicine in Burley, ID

Active since March 10, 2022CLIA 13D2244482 · Waiver
1344 HILAND AVE STE A, BURLEY, ID 83318(208) 678-7246 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 27, 2022, Mar 10, 2022 (2 updates tracked since 2022).

About Magic Valley Pain Specialists, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGIC VALLEY PAIN SPECIALISTS, PLLC (NPI 1003564998) is a healthcare organization registered as a pain medicine in Burley, Idaho and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through December 1, 2027 and lists Tyler C Roe, Owner, as its authorized official.

NPPES Registry Identity

NPI1003564998
Entity TypeOrganization
Primary Taxonomy207LP2900X
Legal Business NameMAGIC VALLEY PAIN SPECIALISTS, PLLC
Location Address1344 HILAND AVE STE ABurley, ID 83318-1564
Mailing AddressPo Box 50979Idaho Falls, ID 83405-0979 · (208) 678-7246
Phone(208) 678-7246
Organization SubpartNo
Authorized OfficialTyler C RoeOwner · (208) 678-7246
Enumeration DateMarch 10, 2022
Last NPPES UpdateSeptember 27, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2022
✔ NPI 1003564998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207LP2900X
Definition
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
1344 HILAND AVE STE A, Burley, ID 83318
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2244482

Magic Valley Pain Specialists · Burley, ID
Active · expires Dec 1, 2027
CLIA Number13D2244482
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2025
Certificate Expiration DateDecember 1, 2027
Laboratory DirectorTyler C. Roe
Laboratory Phone(208) 678-7246
Laboratory LocationMagic Valley Pain Specialists1344 Hiland Ave Suite A, Burley, ID 83318
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH R PETERSEN
Specialist
1344 HILAND AVE STE A
BURLEY, ID 83318
Cassia County (208) 678-1138
TYLER ROE DO
Anesthesiology (Pain Medicine)
1344 HILAND AVE STE A
BURLEY, ID 83318
Cassia County (208) 678-7246
JOSEPH R. PETERSEN, M.D.
Specialist
1344 HILAND AVE STE A
BURLEY, ID 83318
Cassia County (208) 678-1138

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magic Valley Pain Specialists, PLLC's NPI number?

The NPI number for Magic Valley Pain Specialists, PLLC is 1003564998. It was assigned to this organization in the NPPES registry on March 10, 2022.

Where is Magic Valley Pain Specialists, PLLC located?

Magic Valley Pain Specialists, PLLC is located at 1344 Hiland Ave Ste A, Burley, ID 83318. The listed phone number is (208) 678-7246.

What is Magic Valley Pain Specialists, PLLC's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Does Magic Valley Pain Specialists, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2244482) is associated with this NPI, valid through December 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Magic Valley Pain Specialists, PLLC was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.