Individual provider Active NPI

Emily Anne Flannery, MAL, LAT, ATC

  • Athletic Trainer
  • Boise, ID
National Provider Identifier
1235630732
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-550 Issued in ID
Practice address
703 S Americana Blvd Ste 120
Boise, ID 83702-6754
Phone
(208) 489-5543
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-550 ID Primary

Addresses

Primary practice location

703 S Americana Blvd Ste 120
Boise, ID 83702-6754

Mailing address

703 S Americana Blvd Ste 120
Boise, ID 83702-6754
Phone (208) 489-5543

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
AT-550IDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1235630732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 S AMERICANA BLVD STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026754",
            "telephone_number": "208-489-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S AMERICANA BLVD STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026754",
            "telephone_number": "208-489-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "MAL, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-550",
            "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 Feb 21, 2018; 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.