Salome Waitherero Gichuru

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

79818 Issued in ID

Practice address

5391 S Polaris Ave
Meridian, ID 83642-8554

Phone

(208) 760-7635

NPI assigned

Jun 24, 2024

Last updated

Jun 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Salome Waitherero Hayball Former name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dwyer and Harrington, PLLCGroup PAC ID 4981838711, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dwyer & Harrington, PLLC

  dba Omega Mental Health

  • Nurse Practitioner
  • Boise, ID
  • NPI 1568589596
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1235973363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5391 S POLARIS AVE",
            "city": "MERIDAIN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-760-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5391 S POLARIS AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428554",
            "telephone_number": "208-760-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GICHURU",
        "first_name": "SALOME",
        "middle_name": "WAITHERERO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ID",
            "license": "79818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALOME",
            "last_name": "HAYBALL",
            "middle_name": "WAITHERERO",
            "credential": "HAYBALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justin R Gibb, CRNA
• Scott H Gibbons, DC
• Daniel Glen Gibson, PSY.D., M.A., M.S.W.
• Mary Lucia Gibson
• Stephen Gibson
• Maycee Gielow, DO
• Austin Giesige, DDS
• John Perry Giffen, M.D.
• Melissa Gifford, CADC
• Omid Gilani, DDS

• Psychiatric/Mental Health Registered Nurse in Meridian, ID
• Providers in Meridian, ID by specialty
• Psychiatric/Mental Health Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.