NPI age
20 years
Enumerated 2005-06-22
● Active Type 2 · Organization
Surgicare Center Of Idaho, Llc
Surgicare Center Of Idaho, Llc is 1 of 99 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Pennow
Director
Last NPPES update
2016-10-10
Source: monthly bulk 2026-05
How this organization compares
Across 99 active clinic/center providers in Idaho.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 11% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-06Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
360 E Mallard Dr, Ste 125
Boise, ID 837063941
Mailing address
360 E Mallard Dr, Ste 125
Boise, ID 837066644
Authorized official
Louis Pennow, MBA
Director
📞 2083368700
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Ryan Barrett, MD Ophthalmology NPI 1982994844
- Christi Campbell, RN Registered Nurse NPI 1326095233
- Linda Evans, CRNA Nurse Anesthetist, Certified Registered NPI 1093894107
- Mark Hollingshead, M.D. Ophthalmology NPI 1689670911
- Brian McNeel, O.D. Optometrist NPI 1821094152
Specialties
-
Clinic/Center PrimaryDefinition to come...
-
Clinic/CenterDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 273390 |
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.