NPIMap

Individual provider Active NPI

Brittany Guthrie, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1003288648
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1872 Issued in ID
Practice address
1072 N Liberty Street
Ste 303
Boise, ID 83704
Phone
(208) 302-4400
Fax
(208) 302-4255
NPI assigned
Oct 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10109 TX
Physician Assistant 363A00000X PA-1872 ID Primary

Addresses

Primary practice location

1072 N Liberty Street
Ste 303
Boise, ID 83704

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-4400

Other practice location 1

15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487
Phone (713) 442-1700

Other identifiers 1

IdentifierTypeStateIssuer
387256601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160526002384 TX Practitioner - Physician Assistant 6305136680 Reassigns benefits to 2 organizations
I20200803002506 ID Practitioner - Physician Assistant 6305136680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1072 N Liberty St
Boise, ID 83704-8708

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-1872IDMDPhysician Assistant
PA10109TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Aug 1, 2020 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant CurrentSince Aug 1, 2020 Accepting new patients

Locations

1072 N Liberty St
Ste 303
Boise, ID 83704
Phone (208) 302-4200

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: bguthrie1564038@direct.trinity-health.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1003288648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-4400",
            "fax_number": "208-302-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY STREET",
            "address_2": "STE 303",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-302-4400",
            "fax_number": "208-302-4255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770141487",
            "country_code": "US",
            "telephone_number": "713-442-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "BRITTANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10109",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387256601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.