NPIMap

Organization Active NPI

Northwest Nazarene University Health Clinic

  • Family Medicine Physician
  • Nampa, ID
National Provider Identifier
1154928653
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHWEST NAZARENE UNIVERSITY HEALTH CLINIC
Practice address
623 S University Blvd
Nampa, ID 83686-5800
Phone
(208) 467-8643
NPI assigned
Oct 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Carey W Cook, PH.D.
Title
VP Student Life
Phone
(208) 467-8643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

623 S University Blvd
Nampa, ID 83686-5800

Mailing address

623 S University Blvd
Nampa, ID 83686-5800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1154928653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 S UNIVERSITY BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S UNIVERSITY BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865800",
            "telephone_number": "208-467-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST NAZARENE UNIVERSITY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CAREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP STUDENT LIFE",
        "authorized_official_telephone_number": "208-467-8643",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.