NPIMap

Organization Active NPI

Ann Cordum PLLC

  • Internal Medicine Physician
  • Boise, ID
National Provider Identifier
1013383645
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M-7030 Issued in ID
Legal business name
ANN CORDUM PLLC
Practice address
203 W Fort St
Boise, ID 83702-4528
Phone
(208) 994-8656
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Ann Alexandra Cordum, M.D.NPI 1982653879
Title
Owner
Phone
(208) 994-8656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X M-7030 ID Primary

Addresses

Primary practice location

203 W Fort St
Boise, ID 83702-4528

Mailing address

203 W Fort St
Boise, ID 83702-4528
Phone (208) 994-8656

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1013383645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024528",
            "telephone_number": "208-994-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024528",
            "telephone_number": "208-994-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN CORDUM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "CORDUM",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-994-8656",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-7030",
            "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 Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.