NPI age
19 years
Enumerated 2006-08-05
● Active Type 2 · Organization
Spine Institute Of Idaho P A
Spine Institute Of Idaho P A is 1 of 21 orthopaedic surgery organizations in Idaho.
Primary specialty
Orthopaedic Surgery
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Cooper
Office Asst Administrator
Last NPPES update
2016-10-04
Source: monthly bulk 2026-05
How this organization compares
Across 21 active orthopaedic surgery providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
360 E Montvue Dr, Suite 100
Meridian, ID 836426318
Mailing address
360 E Montvue Dr, Suite 100
Meridian, ID 836426318
Authorized official
Tyler Cooper
Office Asst Administrator
📞 2088552900
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Kelli Debooy, PHYSICAL THERAPIST Physical Therapist NPI 1235338682
- Samuel Jorgenson, M.D. Orthopaedic Surgery NPI 1962447169
- Sari Lavarias, PA-C Plastic Surgery NPI 1033454426
- Michael Spackman, MD Physical Medicine & Rehabilitation NPI 1386887032
Specialties
-
Orthopaedic Surgery PrimaryRecognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805983000 |
Practice context
Multi-provider organization. 4 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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.