Boise Valley Asthma & Allergy PA

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

BOISE VALLEY ASTHMA & ALLERGY PA

Practice address

901 N Curtis Rd Ste 100
Boise, ID 83706-1339

Phone

(208) 378-0080

Fax

(208) 378-0259

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Maryann Waugh

Title

Insurance/Credentialing Admin

Phone

(208) 378-0080

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Boise Valley Asthma And Allergy Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 11

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

• Michael V Keiley, MD

  • Allergy & Immunology Physician
  • Boise, ID
  • NPI 1679569149
  Medicare reassignment Care Compare group NPD
• Devon Moser

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1063912202
  Medicare reassignment Care Compare group NPD
• Jennifer Neumayer, NP-C

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1639432131
  Medicare reassignment Care Compare group NPD
• George William Palmer, MD

  • Allergy & Immunology Physician
  • Boise, ID
  • NPI 1033105259
  Medicare reassignment Care Compare group NPD
• Heidi S Peters, NP

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1447246905
  Medicare reassignment Care Compare group NPD
• Sean Craig Stout, MD

  • Allergy & Immunology Physician
  • Boise, ID
  • NPI 1417488131
  Medicare reassignment Care Compare group NPD
• Melissa Kroon, PA

  • Medical Physician Assistant
  • Boise, ID
  • NPI 1962892240
  Medicare reassignment Care Compare group
• Lawrence E Green, M.D.

  • Neurology Physician
  • Nampa, ID
  • NPI 1386692333
  NPD (past)
• Gary Ned Gregerson, M.D.

  • Specialist
  • Nampa, ID
  • NPI 1801834866
  NPD (past)
• Brian Doxey Snow, D.O.

  • Nephrology Physician
  • Nampa, ID
  • NPI 1558680587
  NPD (past)
• Michael D. Kenner, M.D.

  • Cardiovascular Disease Physician
  • Aurora, CO
  • NPI 1417912460
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1215061734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061394",
            "telephone_number": "208-378-0080",
            "fax_number": "208-378-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061339",
            "telephone_number": "208-378-0080",
            "fax_number": "208-378-0259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4424 E Flamingo Ave Ste 340",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836879291",
            "country_code": "US",
            "telephone_number": "208-378-0080",
            "fax_number": "208-378-0259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2320 E Gala St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836424875",
            "country_code": "US",
            "telephone_number": "208-378-0080",
            "fax_number": "208-378-0259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 E Riverside Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836166865",
            "country_code": "US",
            "telephone_number": "208-378-0080",
            "fax_number": "208-378-0259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOISE VALLEY ASTHMA & ALLERGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "WAUGH",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING ADMIN",
        "authorized_official_telephone_number": "208-378-0080"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1374345",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215061734",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boise Valley Asthma And Allergy Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boise Valley Asthma And Allergy Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allergy & Immunology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Allergy & Immunology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.