Active NPI
Ellen B Hunter, M.D.
- Gastroenterology Physician
- Boise, ID
National Provider Identifier
1174518740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- M-8163
- Practice address
- 425 W Bannock St
Boise, ID 83702-6035 - Phone
- (208) 343-1702
- Fax
- (208) 342-7042
- NPI assigned
- Sep 20, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | M-8163 | ID | Primary |
Addresses
Primary practice location
425 W Bannock St
Boise, ID 83702-6035
Mailing address
425 W Bannock St
Boise, ID 83702-6035
Phone (208) 343-1702
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010031134 | Other | ID | BLUE SHIELD OF IDAHO |
| 40550 | Other | ID | BLUE CROSS OF IDAHO |
| 805933400 | Medicaid | ID | |
| 286220 | Other | ID | OREGON HEALTH AND WELFARE |
| P00055513 | Other | ID | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297728000000",
"number": "1174518740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 W BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837026035",
"telephone_number": "208-343-1702",
"fax_number": "208-342-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 W BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837026035",
"telephone_number": "208-343-1702",
"fax_number": "208-342-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTER",
"first_name": "ELLEN",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-20",
"last_updated": "2011-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "ID",
"license": "M-8163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF IDAHO",
"identifier": "000010031134",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "40550",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805933400",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON HEALTH AND WELFARE",
"identifier": "286220",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00055513",
"state": "ID"
}
],
"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 15, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.