Active NPI
Tara Marie Davidson, MD
- Internal Medicine Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- U2470
- Practice address
- 100 E Idaho St
Boise, ID 83712-6267 - Phone
- (208) 381-2711
- Fax
- (208) 381-4025
- NPI assigned
- Apr 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | U2470 | TX | Primary |
| Internal Medicine Physician | 207R00000X | 67727 | MN | |
| Medical Oncology Physician | 207RX0202X | 7271557 | ID | |
| Internal Medicine Physician | 207R00000X | 30238 | MN |
Addresses
Primary practice location
100 E Idaho St
Boise, ID 83712-6267
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6161
Other practice location 2
200 1st St SW
Rochester, MN 55905-0002
Phone (507) 284-2511
Other practice location 3
3884 S Morningwind Ave
Boise, ID 83706-5900
Phone (208) 761-0263
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Idaho St
Boise, ID 83712-6267
Phone (208) 381-2711
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S Elmore Medical Center
- St Luke'S McCall
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30238 | MN | MD | Internal Medicine Physician |
| U2470 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Internal Medicine | Current | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
100 E Idaho St
Ste 210
Boise, ID 83712
100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
Internal Medicine
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- McCall, ID
- NPI 1235447970
-
- Critical Access Hospital
- Mountain Home, ID
- NPI 1699013565
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1164085452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E IDAHO ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126267",
"telephone_number": "208-381-2711",
"fax_number": "208-381-4025"
}
],
"practiceLocations": [
{
"address_1": "1515 Holcombe Blvd",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770304000",
"country_code": "US",
"telephone_number": "713-792-6161",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 1st St SW",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MN",
"postal_code": "559050002",
"country_code": "US",
"telephone_number": "507-284-2511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3884 S Morningwind Ave",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837065900",
"country_code": "US",
"telephone_number": "208-761-0263",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIDSON",
"first_name": "TARA",
"middle_name": "MARIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-22",
"last_updated": "2025-09-11",
"certification_date": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "U2470",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "67727",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "ID",
"license": "7271557",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "30238",
"primary": false
}
],
"identifiers": [],
"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 Sep 11, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.