Individual provider Active NPI

John Preston Cramer, LPC

  • Counselor
  • Boise, ID
National Provider Identifier
1063841856
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LCPC-7041 Issued in ID
Practice address
400 N Benjamin LN Ste 201
Boise, ID 83704-5094
Phone
(208) 287-5600
Fax
(208) 287-5609
NPI assigned
Nov 2, 2013
Last updated
May 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-5447 ID
Counselor 101Y00000X LCPC-7041 ID Primary

Addresses

Primary practice location

400 N Benjamin LN Ste 201
Boise, ID 83704-5094

Mailing address

400 N Benjamin LN Ste 201
Boise, ID 83704-5094
Phone (208) 287-5600

Other identifiers 1

IdentifierTypeStateIssuer
1285767574MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-7041IDMDCounselor
LPC-5447IDMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ada County Juvenile Court Services Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1063841856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N BENJAMIN LN STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045094",
            "telephone_number": "208-287-5600",
            "fax_number": "208-287-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BENJAMIN LN STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045094",
            "telephone_number": "208-287-5600",
            "fax_number": "208-287-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAMER",
        "first_name": "JOHN",
        "middle_name": "PRESTON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-02",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-5447",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-7041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285767574",
            "state": "ID"
        }
    ],
    "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 May 12, 2020; 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.