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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: August 02, 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
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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 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.

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.

MS. JANA M QUALLS FNP
Nurse Practitioner (Family)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 957-7808
HEATHER LOUISE KING NP-C
Nurse Practitioner (Family)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 763-8920
DESIREE HART NP-BC
Nurse Practitioner
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 957-7808
REVITALIZE HEALTH
Nurse Practitioner (Family)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 763-8920
RATHDRUM CLINIC, INC.
Family Medicine (Addiction Medicine)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 819-7103
MRS. LESLEY SUSANNE ROBERTS PA-C
Physician Assistant (Medical)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 819-7103
DR. MICHAEL DAVID WHITING M.D.
Family Medicine
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 819-7103
KIMBERLY MCDERMOTT FNP-BC
Nurse Practitioner (Family)
913 W CANFIELD AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 819-7103

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.

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.

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.