Active NPI
Mary Parsons
- Surgical Assistant
- Eagle, ID
National Provider Identifier
1104205962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 590 W Two Rivers Dr
Eagle, ID 83616-7121 - Phone
- (208) 880-0630
- NPI assigned
- May 27, 2015
- Last updated
- May 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | NU | Primary |
Addresses
Primary practice location
590 W Two Rivers Dr
Eagle, ID 83616-7121
Mailing address
590 W Two Rivers Dr
Eagle, ID 83616-7121
Phone (208) 880-0630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432684800000",
"number": "1104205962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 W TWO RIVERS DR",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167121",
"telephone_number": "208-880-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 W TWO RIVERS DR",
"city": "EAGLE",
"state": "ID",
"postal_code": "836167121",
"telephone_number": "208-880-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARSONS",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-27",
"last_updated": "2015-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.