NPI age
18 years
Enumerated 2007-11-27
● Active Type 2 · Organization
Interventional Pain Consultants PA
Interventional Pain Consultants PA is 1 of 1263 physician assistant organizations in Idaho.
Primary specialty
Physician Assistant
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Grissom
Owner/director
Last NPPES update
2007-11-27
Source: monthly bulk 2026-05
How this organization compares
Across 1263 active physician assistant providers in Idaho.
NPI age
18 years
↑ 9 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-11Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2841 Juniper Dr
Lewiston, ID 835014719
Mailing address
2841 Juniper Dr
Lewiston, ID 835014719
Authorized official
John Thomas Grissom, MD
Owner/director
📞 2087439712
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Jennifer Creaser, ARNP Nurse Practitioner NPI 1588772461
- Ryan Daly, DNP Nurse Practitioner NPI 1356124432
- Craig Flinders, M.D. Pain Medicine NPI 1760403893
- Randall Harper, PH.D., M.ED., B.S.ED Counselor NPI 1659493385
- Garrett Mockler, MD Family Medicine NPI 1205356144
- Lyndal Stoutin, M.D. Pain Medicine NPI 1245240761
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Practice context
Multi-provider organization. 6 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.