Individual provider Active NPI

Tina Michelle Thorne, AGNP

  • Adult Health Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1063970168
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
60947 Issued in ID
Practice address
512 5TH Ave S
Nampa, ID 83651-4153
Phone
(208) 250-7653
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 60947 ID Primary
Nurse Practitioner 363L00000X 60947 ID

Addresses

Primary practice location

512 5TH Ave S
Nampa, ID 83651-4153

Mailing address

512 5TH Ave S
Nampa, ID 83651-4153
Phone (208) 250-7653

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
I20221106000095 ID Practitioner - Nurse Practitioner 8123495090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dandg Medical Associates PLLC 16 clinicians
Community Health Clinics Inc 75 clinicians

Practice addresses (Care Compare)

1430 W Ustick Rd
Suite 100
Meridian, ID 83646-7734
Phone (208) 286-8670

207 1St St S
Nampa, ID 83651-3703
Phone (208) 466-7869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
D&G Medical Associates PLLC CurrentSince Oct 1, 2022 Accepting new patients
Community Health Clinics, Inc. Nurse Practitioner CurrentSince Jan 20, 2026 Accepting new patients
Community Health Clinics, Inc. CurrentSince Jan 20, 2026 Accepting new patients

Locations

200 W Beech St
Caldwell, ID 83605
Phone (208) 459-3335

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

1430 W Ustick Rd
Ste 100
Meridian, ID 83646

46 N Midland Blvd
Nampa, ID 83651
Phone (208) 446-7803

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCBGBD

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1063970168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 5TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514153",
            "telephone_number": "208-250-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 5TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514153",
            "telephone_number": "208-250-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNE",
        "first_name": "TINA",
        "middle_name": "MICHELLE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "60947",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "60947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.