Individual provider Active NPI

Elizabeth Ann List, PSYD

  • Psychologist
  • Nampa, ID
National Provider Identifier
1205055613
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-202790 Issued in ID
Practice address
823 E Amity Ave
Nampa, ID 83686-1053
Phone
(208) 467-8428
NPI assigned
Apr 24, 2007
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-202790 ID Primary

Addresses

Primary practice location

823 E Amity Ave
Nampa, ID 83686-1053

Mailing address

623 S University Blvd
Nampa, ID 83686-5800
Phone (503) 758-2881

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181107003439 ID Practitioner - Psychiatry 1850645946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nnu Health IncGroup PAC ID 3072964238, 4 clinicians

Practice addresses (Care Compare)

823 E Amity Ave
Nampa, ID 83686-5800
Phone (208) 467-8428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nnu Health Inc. CurrentSince Jun 16, 2025 Accepting new patients

Locations

623 S University Blvd
Nampa, ID 83686
Phone (208) 250-0836

823 E Amity Ave
Nampa, ID 83686
Phone (208) 467-8428

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1205055613",
    "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",
            "telephone_number": "503-758-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 E AMITY AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836861053",
            "telephone_number": "208-467-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ID",
            "license": "PSY-202790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.