Blue Lakes Medicine PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1688A Issued in ID

Legal business name

BLUE LAKES MEDICINE PA

Practice address

1122 Eastland Dr N
Ste 2
Twin Falls, ID 83301-8444

Phone

(208) 734-9531

Fax

(208) 733-6969

NPI assigned

Feb 26, 2016

Last updated

Feb 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Howard Rusty Arrington, FNP-C, DCNPI 1063576619

Title

Provider / Owner

Phone

(208) 734-9531

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Howard Rusty Arrington, D.C.

  • Nurse Practitioner
  • Twin Falls, ID
  • NPI 1063576619
  Medicare reassignment NPD Authorized official
• Dustin Tsuyoshi Nukaya, DC

  • Chiropractor
  • Twin Falls, ID
  • NPI 1902638208
  NPD
• Joshua Boone Olsen, DC

  • Chiropractor
  • Burley, ID
  • NPI 1962599472
  NPD
• Tanner Wray, DC

  • Chiropractor
  • Twin Falls, ID
  • NPI 1063987147
  NPD
• Geoffroi Andre Golay, D.C.

  • Chiropractor
  • Twin Falls, ID
  • NPI 1841354495
  NPD (past)

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1063872489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 EASTLAND DR N",
            "address_2": "STE 2",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018444",
            "telephone_number": "208-734-9531",
            "fax_number": "208-733-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 EASTLAND DR N",
            "address_2": "STE 2",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018444",
            "telephone_number": "208-734-9531",
            "fax_number": "208-733-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LAKES MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "ARRINGTON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "RUSTY",
        "authorized_official_title_or_position": "PROVIDER / OWNER",
        "authorized_official_telephone_number": "208-734-9531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP-C, DC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1688A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1374328",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky L Bloxham I, LSW
• Blue Lakes Anesthesia
• Blue Lakes Chiropractic, PA
• Blue Lakes Gastroenterology PLLC
• Blue Lakes Gastroenterology, PLLC
• Bluebird Bio-Consulting, LLC
• Body & Mind Wellness LLC
• Bodybalance PT Twin Falls LLC (BodyBalance Physical Therapy)
• Gregary R Boehme, DMD
• Eric Bohm

• Family Nurse Practitioner in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.