Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Idaho Sports Medicine Institute PA

Organization Sports Medicine (Neuromusculoskeletal Medicine) Physician · NPI 1154356624

Idaho Sports Medicine Institute PA provides Sports Medicine (Neuromusculoskeletal Medicine) Physician services in Boise, Idaho. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1188 University Dr
Boise, ID 83706-3009
Phone: (208) 336-8250
Fax: (208) 345-9514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Neuromusculoskeletal Medicine) Physician (primary) Taxonomy 204C00000X · Licence N/A FOR GROUP

Record details

NPI number1154356624
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Millier — Owner/Partner · (208) 336-8250
NPI enumeratedJuly 12, 2006
Last updated in NPPESJanuary 6, 2026
Certification dateJanuary 6, 2026
Mailing address1188 W University Dr, Boise, ID 83706-3009

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