Organization Active NPI

Ninon Germain MD PLLC

  • Child & Adolescent Psychiatry Physician
  • Boise, ID
National Provider Identifier
1104135375
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
M8955 Issued in ID
Legal business name
NINON GERMAIN MD PLLC
Practice address
413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone
(208) 323-1125
Fax
(208) 323-9604
NPI assigned
Oct 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Ms. Alison Dunbar
Title
Reimbursement Manager
Phone
(208) 323-1125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X M8955 ID Primary

Addresses

Primary practice location

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219

Mailing address

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone (208) 323-1125

Other identifiers 1

IdentifierTypeStateIssuer
1550780OtherIDPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110104000816 ID Part B Supplier - Clinic/Group Practice 4688863814 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1104135375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINON GERMAIN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "DUNBAR",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "208-323-1125",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ID",
            "license": "M8955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "1550780",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.