Individual provider Active NPI

Sadie Nicole Carlsen, NP-C

  • Family Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1225834237
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3971243 Issued in ID
Practice address
211 E Pine Ave Ste 105
Meridian, ID 83642-2321
Phone
(208) 713-7690
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3971243 ID Primary

Addresses

Primary practice location

211 E Pine Ave Ste 105
Meridian, ID 83642-2321

Mailing address

211 E Pine Ave Ste 105
Meridian, ID 83642-2321
Phone (208) 871-5303

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028002976 ID Practitioner - Nurse Practitioner 2668961921 Reassigns benefits to 1 organization
Practice locations: Meridian, ID

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

211 E Pine Ave
Suite 105
Meridian, ID 83642-2321
Phone (208) 871-5303

2900 N Linder Rd
Kuna, ID 83634-5007

Address 4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3971243IDMDFamily Nurse Practitioner

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1225834237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E PINE AVE STE 105",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422321",
            "telephone_number": "208-871-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E PINE AVE STE 105",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422321",
            "telephone_number": "208-713-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "SADIE",
        "middle_name": "NICOLE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "3971243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.