Individual provider Active NPI

Mary Hannah Rankin, FNP

  • Family Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1154072205
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
70369 Issued in ID
Practice address
1672 S Woodsage Ave Ste 120
Meridian, ID 83642-8332
Phone
(208) 515-2273
NPI assigned
Jan 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 70369 ID
Family Nurse Practitioner 363LF0000X 70369 ID Primary

Addresses

Primary practice location

1672 S Woodsage Ave Ste 120
Meridian, ID 83642-8332

Mailing address

10850 W Florence Dr Unit 104
Boise, ID 83713-8054
Phone (740) 646-6809

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
I20220309002415 ID Practitioner - Nurse Practitioner 0941695969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meridian Advanced Psychiatry , LLC 25 clinicians

Practice addresses (Care Compare)

1672 S Woodsage Ave
Suite 120
Meridian, ID 83642-7670
Phone (208) 515-2273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70369IDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho State University Current Accepting new patients
Idaho State University CurrentSince Aug 1, 2024 Accepting new patients
Meridian Advanced Psychiatry , LLC CurrentSince Feb 21, 2022 Accepting new patients
Idaho State University CurrentSince Aug 1, 2024 Accepting new patients

Locations

1672 S Woodsage Ave
Ste 120
Meridian, ID 83642
Phone (208) 515-2273

4783 N Summit Way
#100
Meridian, ID 83646

1311 E Central Dr
Meridian, ID 83642
Phone (208) 373-1734

Interoperability endpoints

  • Direct secure messaging: mary.rankin@maph.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1154072205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 W FLORENCE DR UNIT 104",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837138054",
            "telephone_number": "740-646-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 S WOODSAGE AVE STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428332",
            "telephone_number": "208-515-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "MARY",
        "middle_name": "HANNAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "70369",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "70369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.