Individual provider Active NPI

Cameron McHan, FNP-C

  • Family Nurse Practitioner
  • Rupert, ID
National Provider Identifier
1083816334
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP830A Issued in ID
Practice address
1308 8TH St Ste 1
Rupert, ID 83350
Phone
(208) 436-4322
Fax
(208) 436-1312
NPI assigned
May 31, 2007
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP830A ID Primary

Addresses

Primary practice location

1308 8TH St Ste 1
Rupert, ID 83350

Mailing address

1224 8TH Street Ste 1
Rupert, ID 83350-1527
Phone (208) 434-8236

Other identifiers 3

IdentifierTypeStateIssuer
NP830AOtherIDNP LICENSE NUMBER
N23998OtherIDRN LICENSE
M8073867MedicaidID

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
I20111222000241 ID Practitioner - Nurse Practitioner 8325214364 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minidoka Memorial HospitalGroup PAC ID 7315908894, 38 clinicians

Practice addresses (Care Compare)

1218 9TH St
Suite 10
Rupert, ID 83350-2207
Phone (208) 436-8340

1224 8TH St
Rupert, ID 83350-1527
Phone 20843604813167

1308 8TH St
Suite 1
Rupert, ID 83350-1535
Phone 20843604813167

711 G St
Rupert, ID 83350-1612

90 W 142
Rupert, ID 83350-9384

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP830AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minidoka Memorial Hospital Family Medicine CurrentSince Dec 15, 2011 Accepting new patients
Minidoka Memorial Hospital CurrentSince Dec 15, 2011 Accepting new patients
River View Urgent Care & Medical Center Inc CurrentSince Jan 2, 2013 Accepting new patients

Locations

382 N Overland Ave
Burley, ID 83318
Phone (208) 378-7700

1224 8th St
Rupert, ID 83350
Phone (208) 434-8236

1224 8th St
Ste 1
Rupert, ID 83350

1308 8th St
Ste 1
Rupert, ID 83350
Phone (208) 436-4322

Interoperability endpoints

  • Direct secure messaging: cmchan626110@direct.ochin.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1083816334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 8TH STREET STE 1",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501527",
            "telephone_number": "208-434-8236",
            "fax_number": "208-436-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 8TH ST STE 1",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "83350",
            "telephone_number": "208-436-4322",
            "fax_number": "208-436-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHAN",
        "first_name": "CAMERON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP830A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "NP830A",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "N23998",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8073867",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rupert, ID

Sources for this page

Verify at the official NPI Registry.