NPI age
12 years
Enumerated 2014-03-19
● Active Type 2 · Organization
Idaho Center For Regenerative Medicine
Idaho Center For Regenerative Medicine is 1 of 504 internal medicine organizations in Idaho.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Haake
Physician
Last NPPES update
2016-03-17
Source: monthly bulk 2026-05
How this organization compares
Across 504 active internal medicine providers in Idaho.
NPI age
12 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-03Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
868 E Riverside Dr, Suite 170
Eagle, ID 836165412
Mailing address
868 E Riverside Dr, Suite 170
Eagle, ID 836165412
Authorized official
Robert J Haake, D.O.
Physician
📞 2089952802
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Gregory Flint, M.D. Dermatology NPI 1699866822
- Todd Woodward, PA-C Physician Assistant NPI 1609243187
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
Practice context
Multi-provider organization. 2 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.