NPIMap

Individual provider Active NPI

Amy C Drumm, MD

  • Family Medicine Physician
  • Hailey, ID
National Provider Identifier
1083842272
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M11156 Issued in ID
Practice address
1450 Aviation Dr
Ste 100
Hailey, ID 83333-8785
Phone
(208) 788-3434
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M11156 ID Primary
Family Medicine Physician 207Q00000X 60275737 WA

Addresses

Primary practice location

1450 Aviation Dr
Ste 100
Hailey, ID 83333-8785

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

Other names 1

  • Amy C Fouts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131003000100 ID Practitioner - Family Practice 1658521869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171

Hospital & facility affiliations

  • St Lukes Home Care and Hospice Home health agency, Meridian, ID, CCN 137028
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M11156IDMDFamily Medicine Physician
60275737WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic - Wood River LLC Family Medicine CurrentSince Sep 15, 2013 Accepting new patients
Home Healthcare Nursing, LLC PastSince Sep 4, 2013 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1450 Aviation Dr
Ste 100
Hailey, ID 83333
Phone (208) 788-3434

Interoperability endpoints

  • Direct secure messaging: adrumm18989@direct.slhs.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Home NursingOdessa, TX, CCN 747112 Home health agency 5% Or Greater Direct Ownership Interest (15.35%)
Corporate Officer (15.35%)
Operational/Managerial Control (100%)		 Aug 29, 2016
Aug 15, 2017
Aug 29, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1083842272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 AVIATION DR",
            "address_2": "STE 100",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338785",
            "telephone_number": "208-788-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUMM",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M11156",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60275737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FOUTS",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hailey, ID

Sources for this page

Verify at the official NPI Registry.