Staci Jae Thomas, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

5961472 Issued in ID

Practice address

100 E Idaho St Ste 302
Boise, ID 83712-6269

Phone

(208) 343-7501

Fax

(208) 336-8248

NPI assigned

Oct 31, 2024

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EJCJDD
• FHIR API: https://fhir4.healow.com/fhir/r4/EJCJDD/Endpoint/EJCJDD

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Obstetrics & Gynecology

  NPD
• Evolve OBGYN, PLLC

  dba Evolve OBGYN

  • Obstetrics & Gynecology Physician
  • Boise, ID
  • NPI 1306737580
  NPD (past)

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1013739838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST STE 302",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126269",
            "telephone_number": "208-343-7501",
            "fax_number": "208-336-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STACI",
        "middle_name": "JAE",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "5961472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rexy Ann Thomas, MD
• Samuel Thomas, PA-C
• Scott D Thomas, M.D.
• Seth Alden Thomas, PHARMD
• Shelley Thomas, MPT
• Stephanie M Thomas, CCC-SLP, QOM
• Terrell Lee Thomas
• Tosha Thomas
• Vanessa Marie Thomas, PT, DPT
• Aaron L Thomason, NP

• Women's Health Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Women's Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.