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BEACON PAIN CLINIC
NPI 1477941672
Pain Medicine - Interventional Pain Medicine in Boise, ID

Active since December 23, 2014CLIA 13D2015997 · Certificate of Compliance
115 W MAIN ST, 102, BOISE, ID 83702(208) 342-2104(208) 342-4710 Get Directions Write a Review

NPPES record last updated: December 23, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Beacon Pain Clinic NPPES

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

BEACON PAIN CLINIC (NPI 1477941672) is a healthcare organization registered as an interventional pain medicine in Boise, Idaho and active in the NPI registry since December 2014. The organization holds a CLIA Certificate of Compliance certificate valid through March 14, 2028 and lists Rebekah Guy, Physician, as its authorized official.

NPPES Registry Identity

NPI1477941672
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameBEACON PAIN CLINIC
Location Address115 W MAIN ST, 102Boise, ID 83702-7302
Mailing Address115 W Main St, 102Boise, ID 83702-7302 · (208) 342-2104 · Fax (208) 342-4710
Phone(208) 342-2104
Fax(208) 342-4710
Organization SubpartNo
Authorized OfficialRebekah GuyPhysician · (208) 342-2104
Enumeration DateDecember 23, 2014
✔ NPI 1477941672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in ID · M9987
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
115 W MAIN ST, Boise, ID 83702
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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 Compliance 13D2015997

Beacon Pain Clinic · Boise, ID
Active · expires Mar 14, 2028
CLIA Number13D2015997
Laboratory TypePhysician Office
Certificate Effective DateMarch 15, 2026
Certificate Expiration DateMarch 14, 2028
Laboratory DirectorRebekah Guy
Laboratory Phone(208) 342-2104
Laboratory LocationBeacon Pain Clinic115 W Main St Ste 201, Boise, ID 83702
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

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

CENTER FOR PAIN CARE P A
Physical Medicine & Rehabilitation (Pain Medicine)
115 W MAIN ST, SUITE 102
BOISE, ID 83702
Ada County (208) 342-4700
DR. CLINTON MALLARI MD
Physical Medicine & Rehabilitation (Pain Medicine)
115 W MAIN ST, SUITE 102
BOISE, ID 83702
Ada County (208) 342-4700
DR. WILBUR ALLEN RADER M.D.
General Practice
115 W MAIN ST, SUITE 101
BOISE, ID 83702
Ada County (208) 343-3652
AMBULATORY SURGERY CENTER OF BOISE
Clinic/Center (Ambulatory Surgical)
115 W MAIN ST, SUITE 102
BOISE, ID 83702
Ada County (208) 342-4700

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 Beacon Pain Clinic's NPI number?

The NPI number for Beacon Pain Clinic is 1477941672. It was assigned to this organization in the NPPES registry on December 23, 2014.

Where is Beacon Pain Clinic located?

Beacon Pain Clinic is located at 115 W Main St 102, Boise, ID 83702. The listed phone number is (208) 342-2104.

What is Beacon Pain Clinic's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Beacon Pain Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D2015997) is associated with this NPI, valid through March 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beacon Pain Clinic was last updated on December 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.