IDAHO SPORTS MEDICINE INSTITUTE
NPI 1700180445
Clinic/Center - Physical Therapy in Boise, ID
NPI Status: Active since January 10, 2011
Contact Information
1188 W UNIVERSITY DR
BOISE, ID
ZIP 83706
Phone: (208) 336-8250
Fax: (208) 345-9514
- Organization
- Clinic/Center
- Physical Therapy
- CLIA Number: 13D2106073
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-06-2027
About IDAHO SPORTS MEDICINE INSTITUTE
This page provides the complete NPI Profile along with additional information for Idaho Sports Medicine Institute, a provider established in Boise, Idaho operating as a Clinic/center, focusing in physical therapy . The healthcare provider is registered in the NPI registry with number 1700180445 assigned on January 2011. The practitioner's primary taxonomy code is 261QP2000X with license number PT-1825 (ID). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Roy Tweedle (Business Manager)
- NPI
- 1700180445
- Provider Name
- IDAHO SPORTS MEDICINE INSTITUTE
- Entity Type
- Organization
- Location Address
- 1188 W UNIVERSITY DR BOISE, ID 83706
- Location Phone
- (208) 336-8250
- Location Fax
- (208) 345-9514
- Mailing Address
- 1188 W UNIVERSITY DR BOISE, ID 83706
- Mailing Phone
- (208) 336-8250
- Mailing Fax
- (208) 345-9514
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-10-2011
- Last Update Date
- 01-10-2011
- Code Navigator
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
Clinic/Center Physical Therapy
- Taxonomy Code
- 261QP2000X
- Type
- Ambulatory Health Care Facilities
- License No.
- PT-1825
- License State
- ID
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
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
- 13D2106073
- Facility Type
- Physician Office
- Certificate Effective Date
- October 07, 2025
- Certificate Expiration Date
- October 06, 2027
- Laboratory Director
- JACLYN M. COOPERRIDER
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Idaho Sports Medicine Institute in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1700180445, 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
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.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700180445, enumerated as an "organization" on January 10, 2011.
The provider is located at 1188 W UNIVERSITY DR BOISE, ID 83706 and the phone number is (208) 336-8250.
Clinic/Center with taxonomy code 261QP2000X and a focus in Physical Therapy.
