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

NPI Status: Active since March 01, 2011

Contact Information

950 HOSPITAL WAY
STE A
POCATELLO, ID
ZIP 83201
Phone: (208) 478-4522
Fax: (208) 478-2935

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  • Organization
  • Family Medicine
  • Sports Medicine
  • CLIA Number: 13D2072971
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-03-2026

About IDAHO SPORTS & SPINE PLLC

This page provides the complete NPI Profile along with additional information for Idaho Sports & Spine Pllc, a primary care provider established in Pocatello, Idaho operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1033417035 assigned on March 2011. The practitioner's primary taxonomy code is 207QS0010X with license number O-0400 (ID). The provider is registered as an organization and their NPI record was last updated 7 years ago. Idaho Sports & Spine Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's former legal business name is Christopher R Johnson Do, Pllc. The authorized official of this NPI record is Stephen Hansen D.o. (Owner)

NPI
1033417035
Provider Legal Name
IDAHO SPORTS & SPINE PLLC
Other Organization Name
CHRISTOPHER R JOHNSON DO, PLLC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
950 HOSPITAL WAY STE A POCATELLO, ID 83201
Location Phone
(208) 478-4522
Location Fax
(208) 478-2935
Mailing Address
950 HOSPITAL WAY STE A POCATELLO, ID 83201
Mailing Phone
(208) 478-4522
Mailing Fax
(208) 478-2935
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-01-2011
Last Update Date
11-04-2019
Code Navigator

A primary care provider (PCP) like Idaho Sports & Spine Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
License No.
O-0400
License State
ID
Taxonomy Description
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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

STEPHEN HANSEN D.O.

Authorized Official Title
OWNER
Authorized Official Phone
(208) 478-4522

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D2072971
Facility Type
Physician Office
Certificate Effective Date
October 04, 2024
Certificate Expiration Date
October 03, 2026
Laboratory Director
STEPHEN M. HANSEN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Idaho Sports & Spine Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1033417035, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
3
Doubled → 6
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
0
Unchanged
Pos 9
3
Doubled → 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 4 → 8 7 → 14 → 5 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 6 + 3 + 8 + 1 + 1 + 4 + 0 + 6 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1033417035.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

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
Physician Assistant
950 HOSPITAL WAY, STE A
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
Physician Assistant (Medical)
950 HOSPITAL WAY, SUITE 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.