NPIMap

Individual provider Active NPI

Alysha Kathryn Schlack, NP-C

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1144886516
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-60174 Issued in ID
Practice address
1075 N Curtis Rd Ste 200
Boise, ID 83706
Phone
(208) 302-2000
Fax
(208) 302-2055
NPI assigned
May 11, 2019
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-60174 ID Primary

Addresses

Primary practice location

1075 N Curtis Rd Ste 200
Boise, ID 83706

Mailing address

3340 E Goldstone Dr.
Meridian, ID 83642
Phone (208) 302-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191120001738 ID Practitioner - Nurse Practitioner 0840622437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

4424 E Flamingo Ave
Nampa, ID 83687-9306

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-60174IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2019 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2019 Accepting new patients
Saint Alphonsus Medical Center Nampa, Inc. Past Accepting new patients

Locations

1075 N Curtis Rd
Ste 200
Boise, ID 83706
Phone (208) 323-0031

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

4400 E Flamingo Ave
Ste 302
Nampa, ID 83687
Phone (208) 302-2200

4424 E Flamingo Ave
Ste 210
Nampa, ID 83687
Phone (208) 302-2000

Interoperability endpoints

  • Direct secure messaging: aschlack1564320@direct.trinity-health.org

Organizations & group practices 4

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 8

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": "1557532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1144886516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR.",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-2000",
            "fax_number": "208-302-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N CURTIS RD STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-302-2000",
            "fax_number": "208-302-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLACK",
        "first_name": "ALYSHA",
        "middle_name": "KATHRYN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-11",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "CNP-60174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.