Active NPI
Jeffrey B. Symmonds, MD
- Vascular Surgery Physician
- Boise, ID
National Provider Identifier
1154370328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- M5182
- Practice address
- 6140 W Curtisian
Suite 300
Boise, ID 83704 - Phone
- (208) 367-7787
- Fax
- (208) 367-7798
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | M5182 | ID | Primary |
Addresses
Primary practice location
6140 W Curtisian
Suite 300
Boise, ID 83704
Mailing address
3340 East Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003956300 | Medicaid | ID | |
| 020029312 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5182 | ID | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265241600000",
"number": "1154370328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 EAST GOLDSTONE WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421026",
"telephone_number": "208-367-5170",
"fax_number": "208-367-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 W CURTISIAN",
"address_2": "SUITE 300",
"city": "BOISE",
"state": "ID",
"postal_code": "83704",
"telephone_number": "208-367-7787",
"fax_number": "208-367-7798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYMMONDS",
"first_name": "JEFFREY",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2010-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "ID",
"license": "M5182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003956300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "020029312",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.