Laura Joanne Bainbridge, FNP-C, APRN, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1438A Issued in ID

Practice address

203 W. Main Street
Boise, ID 83702

Phone

(208) 336-7722

Fax

(208) 336-9284

NPI assigned

May 9, 2007

Last updated

Jan 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Laura Joanne Dittmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

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.

• Main Family Medical

  • Family Medicine Physician
  • Boise, ID
  • NPI 1023498920
  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1144434556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W. MAIN STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-336-7722",
            "fax_number": "208-336-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W. MAIN STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-336-7722",
            "fax_number": "208-336-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINBRIDGE",
        "first_name": "LAURA",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, APRN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA242",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1438A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "DITTMER",
            "middle_name": "JOANNE",
            "prefix": "MS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nykol Bailey, CRNA
• Peggy S. Bailey, RPT
• Scott Bailey
• Jon-Eric Baillie, M.D.
• Chad Gordon Bainbridge, PTA PHYSICAL THERAPI
• Andrea Baird
• Anna Louise Baird, LPC, NCC
• David M Baird, LCSW
• Emily Baird, LCSW
• William Baisden, RN

• Family Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.