Individual provider Active NPI

Chelsea Anderson, APRN-CPNP

  • Pediatric Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1205653979
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
62951 Issued in ID
Practice address
4740 N Penngrove Way Ste 210
Meridian, ID 83646-7447
Phone
(208) 514-0203
NPI assigned
Sep 24, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 62951 ID Primary

Addresses

Primary practice location

4740 N Penngrove Way Ste 210
Meridian, ID 83646-7447

Mailing address

4740 N Penngrove Way Ste 210
Meridian, ID 83646-7447
Phone (208) 514-0203

Other practice location 1

3090 E Gentry Way Ste 210
Meridian, ID 83642-3550
Phone (208) 514-0203

Other practice location 2

1435 E Phenomenal St
Meridian, ID 83642-1057
Phone (208) 514-0203

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
62951IDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Pediatrics, LLC PastSince Sep 29, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19555/brand/1/csg/1/fhir/r4

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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1205653979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N PENNGROVE WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467447",
            "telephone_number": "208-514-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N PENNGROVE WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467447",
            "telephone_number": "208-514-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3090 E Gentry Way Ste 210",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836423550",
            "country_code": "US",
            "telephone_number": "208-514-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1435 E Phenomenal St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421057",
            "country_code": "US",
            "telephone_number": "208-514-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHELSEA",
        "credential": "APRN-CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "62951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.