OrganizationActive
Advanced Pain Management PLLC
NPI 1114171519 · Pain Medicine (Anesthesiology) Physician · Meridian, ID
Provider details
- NPI number
- 1114171519
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michael Severson, Member(208) 880-9464
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2275 So Eagle Rd
Sute 160
Meridian, ID 83642
Phone: (208) 947-2266
Fax: (208) 947-2267
Street-level locationGet directions
Mailing address
6140 Curtisian Ave
Boise, ID 83704-8880
Registry dates
- Enumerated
- 2008-11-11
- Last updated
- 2011-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.