Rebekah G Fayette, CNM, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Boise, ID
NPI 1043690175 · NPPES record last updated Aug 11, 2025
Key facts
- NPI
- 1043690175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 54388 (ID)
- Practice address
- 4477 W Emerald St Ste C200
Boise, ID 83706-2074 - Phone
- (208) 780-9295
- Fax
- (855) 490-9559
- NPI assigned
- Jun 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161215002288 | ID | Practitioner - Certified Nurse Midwife (CNM) | 6406162841 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54388 | ID | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 5 Peppers Inc. | Psychiatric/Mental Health | Current |
Accepting new patients |
| Summit Psychiatry and Family Wellness | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients | |
| Illumination Women'S Health PLLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients |
Locations
10280 W Ustick Rd
Boise, ID 83704
Phone (208) 780-9295
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
1072 N Liberty St
Ste 100
Boise, ID 83704
Phone (208) 302-1200
4477 W Emerald St
Ste C200
Boise, ID 83706
Phone (208) 780-9295
3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
217 W Georgia Ave
Ste 120
Nampa, ID 83686
Phone (208) 498-1760
1050 SW 3rd Ave
Ste 1600
Ontario, OR 97914
Phone (541) 881-2360
Interoperability endpoints
- rfayette84916@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 54388 | ID | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 54388 | ID | Yes |
Addresses
Primary practice location
4477 W Emerald St Ste C200
Boise, ID 83706-2074
Mailing address
10280 W Ustick Rd
Boise, ID 83704-5270
Phone (208) 780-9295
Other practice location 1
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121
Other names
- Rebekah Tyle
Other providers in Boise, ID
- Nathan Fauntleroy
- William Ernest Faure
- Sarah Maria Fauth
- Landon Mitchel Favero
- Roycie Faye
- Sarah Shanti Fazel
- Katherine Fazio
- Fazzio Clinic PC
- Frank J Fazzio Jr.
- Monika Gerda Fealko
All providers in Boise, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.