IDAHO SPORTS & SPINE PLLC
NPI 1033417035
Family Medicine - Sports Medicine in Pocatello, ID

Active since March 01, 2011CLIA 13D2072971 · Waiver
950 HOSPITAL WAY, STE A, POCATELLO, ID 83201(208) 478-4522(208) 478-2935 Get Directions Write a Review

NPPES record last updated: November 4, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Idaho Sports & Spine Pllc NPPES

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

IDAHO SPORTS & SPINE PLLC (NPI 1033417035), doing business as Christopher R Johnson Do, Pllc, is a healthcare organization registered as a sports medicine in Pocatello, Idaho and active in the NPI registry since March 2011. The organization holds a CLIA Waiver certificate valid through October 3, 2026 and lists Stephen Hansen, Owner, as its authorized official.

NPPES Registry Identity

NPI1033417035
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameIDAHO SPORTS & SPINE PLLC
Location Address950 HOSPITAL WAY, STE APocatello, ID 83201-2789
Mailing Address950 Hospital Way, Ste APocatello, ID 83201-2789 · (208) 478-4522 · Fax (208) 478-2935
Fax(208) 478-2935
Organization SubpartNo
Authorized OfficialStephen HansenOwner · (208) 478-4522
Enumeration DateMarch 1, 2011
Last NPPES UpdateNovember 4, 2019
NPI 1033417035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License Licensed in ID · O-0400
Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

950 HOSPITAL WAY, Pocatello, ID 83201

Other Names 1

Former Legal Business NameChristopher R Johnson Do, Pllc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 13D2072971

Idaho Sports & Spine · Pocatello, ID
Active · expires Oct 3, 2026
CLIA Number13D2072971
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateOctober 3, 2026
Laboratory DirectorStephen M. Hansen
Laboratory Phone(208) 478-4522
Laboratory LocationIdaho Sports & Spine950 Hospital Way #a, Pocatello, ID 83201
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 9

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

Dentist (General Practice)
950 HOSPITAL WAY, SUITE B
POCATELLO, ID 83201
Dentist (General Practice)
950 HOSPITAL WAY, SUITE B
POCATELLO, ID 83201
Dentist (General Practice)
950 HOSPITAL WAY, SUITE B
POCATELLO, ID 83201
Dentist (General Practice)
950 HOSPITAL WAY, SUITE B
POCATELLO, ID 83201
Non-Pharmacy Dispensing Site
950 HOSPITAL WAY
POCATELLO, ID 83201
Orthopaedic Surgery
950 HOSPITAL WAY, STE A
POCATELLO, ID 83201
Pediatrics
950 HOSPITAL WAY, SUITE A
POCATELLO, ID 83201
Orthopaedic Surgery (Sports Medicine)
950 HOSPITAL WAY, STE A
POCATELLO, ID 83201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033417035, enumerated as an "organization" on March 01, 2011.

The provider is located at 950 HOSPITAL WAY STE A POCATELLO, ID 83201 and the phone number is (208) 478-4522.

Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.