Jason Nealy, D.O.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

60961766 Issued in WA

Practice address

4305 N Eagle Rd
Boise, ID 83713-4722

Phone

(208) 939-3110

NPI assigned

Jun 25, 2014

Last updated

Oct 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1245645589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15320 OLD REDMOND RD",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526837",
            "telephone_number": "970-581-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837134722",
            "telephone_number": "208-939-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEALY",
        "first_name": "JASON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "60961766",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "60961766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yves Ndayishimiye
• Claudius Ndifon Ndigamkong
• Ben A Ndisanze
• Jared Neal, AT
• Matthew D Neale, MD
• Kimberly Nealy, DMD
• Joanne Nearman, LPC
• Kaitlin C Neary, M.D.
• Danielle Nebeker, R.D., L.D.
• Trudy Nebeker

• Plastic Surgery Physician in Boise, ID
• Providers in Boise, ID by specialty
• Plastic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.