Individual provider Active NPI

Zachary Friberg, NP

  • Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1144046301
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1071540 Issued in ID
Practice address
660 E Franklin Rd Ste 140
Meridian, ID 83642-2914
Phone
(208) 992-2672
Fax
(877) 569-2323
NPI assigned
Dec 3, 2024
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10036869 OR
Nurse Practitioner 363L00000X 1071540 ID Primary

Addresses

Primary practice location

660 E Franklin Rd Ste 140
Meridian, ID 83642-2914

Mailing address

660 E Franklin Rd Ste 140
Meridian, ID 83642-2914
Phone (208) 992-2672

Other practice location 1

808 N Whitley Dr
Fruitland, ID 83619-2437
Phone (208) 452-2672

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250106003643 ID Practitioner - Nurse Practitioner 7214465152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 N Whitley Dr
Fruitland, ID 83619-2434
Phone (208) 452-2672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10036869ORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ancora Hospice & Palliative Services, LLC CurrentSince Nov 1, 2022 Accepting new patients
Ancora Hospice & Palliative Services, LLC Single Specialty CurrentSince Jan 1, 2025 Accepting new patients

Locations

401 N Whitley Dr
Fruitland, ID 83619
Phone (208) 452-2672

808 N Whitley Dr
Fruitland, ID 83619
Phone (208) 452-2672

660 E Franklin Rd
Ste 140
Meridian, ID 83642
Phone (208) 992-2672

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1144046301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 E FRANKLIN RD STE 140",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422914",
            "telephone_number": "208-992-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 E FRANKLIN RD STE 140",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422914",
            "telephone_number": "208-992-2672",
            "fax_number": "877-569-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 N Whitley Dr",
            "address_purpose": "LOCATION",
            "city": "Fruitland",
            "state": "ID",
            "postal_code": "836192437",
            "country_code": "US",
            "telephone_number": "208-452-2672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIBERG",
        "first_name": "ZACHARY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10036869",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "1071540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.