Individual provider Active NPI

Jennifer Nicole Clure

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1114573052
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8861418 Issued in ID
Practice address
1075 E Park Blvd
Boise, ID 83712-7722
Phone
(208) 381-5970
Fax
(208) 381-5971
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X 8861418 ID Primary

Addresses

Primary practice location

1075 E Park Blvd
Boise, ID 83712-7722

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jclure2005@hotmail.com

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001767 ID Practitioner - Clinical Social Worker 8628596988 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 9, 2025 Accepting new patients

Locations

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

1075 E Park Blvd
Boise, ID 83712
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1114573052",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E PARK BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127722",
            "telephone_number": "208-381-5970",
            "fax_number": "208-381-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLURE",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jclure2005@hotmail.com",
            "affiliation": "N",
            "address_1": "11288 W Bodie River Loop",
            "city": "Nampa",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836865631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.