Cody James Marchetti, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

O-1532 Issued in ID

Practice address

500 W Fort St
#111
Boise, ID 83702-4501

Phone

(208) 380-2301

Fax

(208) 422-1319

NPI assigned

Apr 9, 2018

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1053818955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "#111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "#111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-380-2301",
            "fax_number": "208-422-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHETTI",
        "first_name": "CODY",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "MRM-1712",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O-1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Bostick MD Chartered
• Lesley March
• Elena Marchesan, LPC
• Joseph Nicholas Marchesani, M.D.
• Gabrielle Hope Gequillana Marchese, PHARMD
• Lisa Marconi, R.N.
• Julie Marcum, APRN
• Mariana Counseling and Wellness, LLC
• Mariella L. Hogan, PH.D., Atr-BC, PLLC (Hays Street Counseling)
• Brandi J Marion, M.S., CCC-SLP

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.