JOANNA BORK — NPI 1740605740 (Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric in BOISE, ID)

CMS-1500 Box 24J / 33a • NPI

1740605740

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

133VN1004X (CMS 71)

Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric

Box 32 Service Location & ZIP+4

100 E IDAHO ST, SUITE 200, BOISE, ID, 83712-6267

✓ 9-Digit EDI 837 ZIP+4 (83712-6267)

Practice Phone & Referral Fax

(208) 381-7081

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1740605740 (JOANNA BORK) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1740605740` (NPI-1 Individual Practitioner)
Provider / Legal Name	JOANNA BORK
Plain-English Specialty	Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric NUCC Code: `133VN1004X` (Dietitian, Registered, Nutrition, Pediatric)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	100 E IDAHO ST, SUITE 200, BOISE, ID, 83712-6267
Practice Telephone / Fax	Tel: (208) 381-7081
Administrative Mailing Address	624 N GLEN ASPEN WAY, STAR, ID, 83669-5755
Enumeration & Last Sync	Enumerated: 2014-02-27 \| CMS Record Updated: 2014-02-27

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

100 E IDAHO ST, SUITE 200, BOISE, ID, 83712-6267

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Plain-English Taxonomy & CMS Crosswalk (133VN1004X)

What Does Taxonomy Code 133VN1004X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 133VN1004X translates to:
"Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 71 (Registered Dietitian or Nutrition Professional)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Dietitian, Registered, Nutrition, Pediatric for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JOANNA BORK)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`133VN1004X` — Dietitian, Registered, Nutrition, Pediatric Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric	State: ID \| License: `D-288` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JOANNA BORK (NPI #1740605740)