NPI age
19 years
Enumerated 2006-08-23
● Active Type 2 · Organization
Boise Podiatry Clinic, P. A.
Boise Podiatry Clinic, P. A. is 1 of 11 podiatrist organizations in Idaho.
Primary specialty
Podiatrist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Millward
Administrator
Last NPPES update
2007-12-11
Source: monthly bulk 2026-05
How this organization compares
Across 11 active podiatrist providers in Idaho.
NPI age
19 years
↑ 3 yr above median
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
6051 N Eagle Rd
Boise, ID 83713
Mailing address
6051 N Eagle Rd
Boise, ID 83713
Authorized official
Gary J Millward, DPM
Administrator
📞 2089384670
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Scott Graviet, DPM Podiatrist NPI 1578514618
- Gary Millward, DPM Podiatrist NPI 1063462075
- Dustin Portela, D.O. Dermatology NPI 1588002547
- Jacob Tebbs, PA-C Physician Assistant NPI 1154870251
- Dana Triplitt Denturist NPI 1720920457
- Heidi Van Giffen, L.D. Denturist NPI 1700099694
Specialties
-
Podiatrist PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Podiatry Center of Idaho
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 →
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