NPIMap

Individual provider Active NPI

John B Dever, MD

  • Gastroenterology Physician
  • Meridian, ID
National Provider Identifier
1093918724
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M-16522 Issued in ID
Practice address
875 S Vanguard Way Ste 310
Meridian, ID 83642-8540
Phone
(208) 463-3000
NPI assigned
Jun 8, 2007
Last updated
Nov 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A114858 CA
Gastroenterology Physician 207RG0100X M-16522 ID Primary

Addresses

Primary practice location

875 S Vanguard Way Ste 310
Meridian, ID 83642-8540

Mailing address

215 E Hawaii Ave
Department of Gastroenterology
Nampa, ID 83686
Phone (208) 463-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150615000801 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 1850432766 Reassigns benefits to 1 organization
I20220701000654 ID Practitioner - Internal MedicinePractitioner - Gastroenterology 1850432766 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Gastroenterology Associates LLPGroup PAC ID 6002708773, 35 clinicians

Practice addresses (Care Compare)

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 489-1431

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy139
Upper gastrointestinal (GI) endoscopy for acid reflux329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114858CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Gastroenterology Associates, LLP Gastroenterology CurrentSince Jun 1, 2024 Accepting new patients
Regents of the University of California - Ucsd Medical Group Gastroenterology CurrentSince Apr 18, 2015 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Apr 18, 2015 Accepting new patients
Southern Idaho Health Partners LLC CurrentSince Jul 1, 2022 Accepting new patients
Boise Endoscopy Center, LLC PastSince Jul 1, 2025 Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

200 W Arbor Dr
#8201
San Diego, CA 92103
Phone (858) 534-6290

425 W Bannock St
Boise, ID 83702
Phone (208) 343-1702

2235 E Gala St
Meridian, ID 83642
Phone (208) 489-1431

875 S Vanguard Way
Ste 300
Meridian, ID 83642
Phone (208) 960-0650

875 S Vanguard Way
Ste 310
Meridian, ID 83642
Phone (208) 343-6458

1200 Garrity Blvd
Nampa, ID 83687
Phone (208) 343-6458

1216 Garrity Blvd
Nampa, ID 83687
Phone (208) 342-7169

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

Organizations & group practices 9

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 3

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1093918724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "address_2": "DEPARTMENT OF GASTROENTEROLOGY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "208-463-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY STE 310",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428540",
            "telephone_number": "208-463-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVER",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A114858",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M-16522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.