1. Home
  2. Directory
  3. Idaho
  4. Coeur D Alene
  5. Pain Medicine
  6. NPI Profile

MIND AND BODY RESTORED
NPI 1295420651
Pain Medicine - Pain Medicine in Coeur D Alene, ID

Active since April 10, 2023CLIA 13D2313728 · Waiver
913 W CANFIELD AVE, COEUR D ALENE, ID 83815(208) 957-7808(949) 695-2456 Get Directions Write a Review

NPPES record last updated: December 5, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 5, 2023, May 2, 2023, Apr 10, 2023 (3 updates tracked since 2023).

About Mind And Body Restored NPPES

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

MIND AND BODY RESTORED (NPI 1295420651) is a healthcare organization registered as a pain medicine in Coeur D Alene, Idaho and active in the NPI registry since April 2023. The organization holds a CLIA Waiver certificate valid through November 5, 2026 and lists Jana Quall, Np, as its authorized official.

NPPES Registry Identity

NPI1295420651
Entity TypeOrganization
Primary Taxonomy208VP0000X
Legal Business NameMIND AND BODY RESTORED
Location Address913 W CANFIELD AVECoeur D Alene, ID 83815-9764
Mailing Address3117 W Augustin DrCoeur D Alene, ID 83815-5362 · (208) 957-7808 · Fax (949) 695-2456
Phone(208) 957-7808
Fax(949) 695-2456
Organization SubpartNo
Authorized OfficialJana QuallNp · (208) 957-7808
Enumeration DateApril 10, 2023
Last NPPES UpdateDecember 5, 20233 updates tracked since enumeration
NPPES CertifiedDecember 5, 2023
✔ NPI 1295420651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0000X
Definition
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X
913 W CANFIELD AVE, Coeur D Alene, ID 83815
Open in Google Maps ↗

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mind And Body Restored is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Mind And Body Restored, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Desiree Hart, NP-BC
Nurse Practitioner
NPI 1336888478
913 W CANFIELD AVE
Coeur D Alene, ID 83815
(208) 957-7808
✔ PECOS✔ Accepts MedicareSame address
Holly Murray, FNP
Nurse Practitioner
NPI 1831677681
913 W CANFIELD AVE
Coeur D Alene, ID 83815
(208) 819-7103
✔ PECOS✔ Accepts MedicareSame address
Jana Qualls, FNP
Nurse Practitioner
NPI 1083670889
913 W CANFIELD AVE
Coeur D Alene, ID 83815
(208) 957-7808
✔ PECOS✔ Accepts MedicareSame address
Jill White, ARNP
Nurse Practitioner
NPI 1073837472
3700 W SELTICE WAY
Coeur D Alene, ID 83814
(208) 620-5255
✔ PECOS✔ Accepts Medicare2.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 13D2313728

Mind And Body Restored · Coeur D'alene, ID
Active · expires Nov 5, 2026
CLIA Number13D2313728
Laboratory TypePractitioner Other
Certificate Effective DateNovember 6, 2024
Certificate Expiration DateNovember 5, 2026
Laboratory DirectorJana M. Qualls
Laboratory Phone(208) 957-7808
Laboratory LocationMind And Body Restored913 W Canfield Ave, Coeur D'alene, ID 83815
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Mind And Body Restored's NPI number?

The NPI number for Mind And Body Restored is 1295420651. It was assigned to this organization in the NPPES registry on April 10, 2023.

Where is Mind And Body Restored located?

Mind And Body Restored is located at 913 W Canfield Ave, Coeur D Alene, ID 83815. The listed phone number is (208) 957-7808.

What is Mind And Body Restored's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Is Mind And Body Restored enrolled in Medicare?

Yes. Mind And Body Restored is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mind And Body Restored?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mind And Body Restored. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mind And Body Restored hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2313728) is associated with this NPI, valid through November 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mind And Body Restored accept?

Health plans from Molina Healthcare list Mind And Body Restored as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mind And Body Restored was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.