Individual provider Active NPI

Cheryl Fish, NP

  • Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1083185235
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
60167 Issued in ID
Practice address
2667 E Gala CT Ste 110
Meridian, ID 83642-2791
Phone
(208) 944-2354
NPI assigned
Dec 16, 2018
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95010116 CA
Nurse Practitioner 363L00000X 60167 ID Primary
Registered Nurse 163W00000X 807738 CA
Nurse Practitioner 363L00000X 95010116 CA

Addresses

Primary practice location

2667 E Gala CT Ste 110
Meridian, ID 83642-2791

Mailing address

2667 E Gala CT Ste 110
Meridian, ID 83642-2791
Phone (208) 944-2354

Other practice location 1

6140 W Curtisian Ave
Ste 200
Boise, ID 83704
Phone (208) 302-0000

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
I20190719002496 ID Practitioner - Nurse Practitioner 2466793179 Receives reassigned benefits from 4 practitioners
Practice locations: Meridian, ID

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Primary Care, LLC CurrentSince Nov 4, 2024 Accepting new patients
Legacy Primary Care, PLLC Family Medicine Past Accepting new patients

Locations

2273 E Gala St
Ste 120
Meridian, ID 83642
Phone (208) 247-1721

Practitioners & affiliated clinicians

Practitioners 4

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.

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, 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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1083185235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 E GALA CT STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422791",
            "telephone_number": "208-944-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 E GALA CT STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422791",
            "telephone_number": "208-944-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 W Curtisian Ave",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "83704",
            "country_code": "US",
            "telephone_number": "208-302-0000",
            "fax_number": "208-302-0055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISH",
        "first_name": "CHERYL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95010116",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "60167",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "807738",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.