Active NPI
Julia Marie Jensen, DO
- Sports Medicine (Family Medicine) Physician
- Boise, ID
National Provider Identifier
1003819509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- O-0719
- Practice address
- 111 W Main St Ste 100
Boise, ID 83702-7261 - Phone
- (208) 342-7400
- Fax
- (208) 342-1979
- NPI assigned
- May 27, 2005
- Last updated
- Mar 16, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | O-0719 | ID | Primary |
Addresses
Primary practice location
111 W Main St Ste 100
Boise, ID 83702-7261
Mailing address
111 W Main St
Boise, ID 83702-7261
Phone (208) 342-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 10, 2020 through Sep 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Lifetime Health | Family Medicine | Past | Accepting new patients |
| Gregory M Jackson, MD, PA | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DJFAAA/Endpoint/DJFAAA
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Colleen Shackelford, LLC
- Family Medicine Physician
- Boise, ID
- NPI 1689744963
-
- Family Medicine Physician
- San Antonio, TX
- NPI 1861670994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1003819509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W MAIN ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837027261",
"telephone_number": "208-342-7400",
"fax_number": "208-342-1879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W MAIN ST STE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837027261",
"telephone_number": "208-342-7400",
"fax_number": "208-342-1979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "JULIA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-27",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "ID",
"license": "O-0719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.