Individual provider Active NPI

Christina Marie Medley, B.A.

  • Community/Behavioral Health Agency
  • Boise, ID
National Provider Identifier
1235007485
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
10096 W Fairview Ave Ste 160
Boise, ID 83704-5004
Phone
(208) 908-7882
Fax
(208) 908-7883
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ID Primary

Addresses

Primary practice location

10096 W Fairview Ave Ste 160
Boise, ID 83704-5004

Mailing address

4408 W Hoover St
Boise, ID 83705-1315
Phone (208) 906-7882

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
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Avanzar Wellness LLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

10096 W Fairview Ave
Ste 160
Boise, ID 83704
Phone (208) 908-7882

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1235007485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 W HOOVER ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051315",
            "telephone_number": "208-906-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10096 W FAIRVIEW AVE STE 160",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045004",
            "telephone_number": "208-908-7882",
            "fax_number": "208-908-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 28, 2025; 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.