Individual provider Active NPI

Courtney M Combe, PA-C

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1053740290
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1121 Issued in ID
Practice address
3071 E Franklin Rd Ste 201
Meridian, ID 83642-2376
Phone
(208) 807-2877
Fax
(208) 207-2888
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-1121 ID
Physician Assistant 363A00000X PA-1121 ID Primary

Addresses

Primary practice location

3071 E Franklin Rd Ste 201
Meridian, ID 83642-2376

Mailing address

1775 W State St # 383
Boise, ID 83702-3924
Phone (208) 912-4416

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140414000073 ID Practitioner - Physician Assistant 7618107293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Associates Services PLLCGroup PAC ID 7315339785, 4 clinicians

Practice addresses (Care Compare)

1019 W Sanetta St
Nampa, ID 83651-5047
Phone (208) 462-3392

1031 W Sanetta St
Nampa, ID 83651-5047
Phone (208) 462-3392

1775 W State St
Suite 383
Boise, ID 83702-3924

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1121IDMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1053740290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W STATE ST # 383",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023924",
            "telephone_number": "208-912-4416",
            "fax_number": "208-549-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 E FRANKLIN RD STE 201",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422376",
            "telephone_number": "208-807-2877",
            "fax_number": "208-207-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBE",
        "first_name": "COURTNEY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1121",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.