OrganizationActive
Mind and Body Restored
NPI 1295420651 · Pain Medicine Physician · Coeur D Alene, ID
Provider details
- NPI number
- 1295420651
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jana Quall, NP(208) 957-7808
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
913 W Canfield Ave
Coeur D Alene, ID 83815-9764
Phone: (208) 957-7808
Fax: (949) 695-2456
Street-level locationGet directions
Mailing address
3117 W Augustin Dr
Coeur D Alene, ID 83815-5362
Registry dates
- Enumerated
- 2023-04-10
- Last updated
- 2023-12-05
- Certified
- 2023-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.