Nicole Marie Maxwell, NMD

Primary specialty

NaturopathTaxonomy code 175F00000X

License

NT00001153 Issued in WA

Practice address

4219 W Emerald St
Boise, ID 83706-2036

Phone

(208) 338-0405

Fax

(208) 422-9957

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boise Natural Health, Inc

  • Naturopath
  • Boise, ID
  • NPI 1083742233
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1083772065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4219 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062036",
            "telephone_number": "208-338-0405",
            "fax_number": "208-422-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062036",
            "telephone_number": "208-338-0405",
            "fax_number": "208-422-9957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17510 Vashon Highway SW",
            "address_purpose": "LOCATION",
            "city": "Vashon",
            "state": "WA",
            "postal_code": "98070",
            "country_code": "US",
            "telephone_number": "206-463-1480",
            "fax_number": "800-688-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "201450836",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare Services, Inc.
• Douglas Maxson
• William Maxson, DS
• James R Maxwell, M.D.
• Kollette Frances Maxwell
• Noah D Maxwell, PT
• Allison Elisabeth May
• Matthew Joihn May, M.D.
• Rose Hope May, CMT
• Jacqueline Maybach, M.D.

• All providers in Boise, ID
• Naturopath in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.