Individual provider Active NPI

Annette Mary Tuft, FNP

  • Family Nurse Practitioner
  • Rexburg, ID
National Provider Identifier
1255005104
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58901 Issued in ID
Practice address
404 N 2ND E
Rexburg, ID 83440-1608
Phone
(208) 359-1770
Fax
(208) 359-1780
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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 58901 ID Primary

Addresses

Primary practice location

404 N 2ND E
Rexburg, ID 83440-1608

Mailing address

859 S Yellowstone Hwy Ste 3201
Rexburg, ID 83440-6200
Phone (208) 359-2101

Other practice location 1

859 S Yellowstone Hwy Ste 3201
Rexburg, ID 83440-6200
Phone (208) 359-2101

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
I20211020001536 ID Practitioner - Nurse Practitioner 1557759743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2725 Channing Way
Idaho Falls, ID 83404-7510
Phone (208) 525-8448

Hospital & facility affiliations

  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58901IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Idaho Mental Health LLC CurrentSince May 7, 2024 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

859 S Yellowstone Hwy
Ste 3201
Rexburg, ID 83440
Phone (208) 359-2101

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1255005104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 S YELLOWSTONE HWY STE 3201",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834406200",
            "telephone_number": "208-359-2101",
            "fax_number": "208-356-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401608",
            "telephone_number": "208-359-1770",
            "fax_number": "208-359-1780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "859 S Yellowstone Hwy Ste 3201",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834406200",
            "country_code": "US",
            "telephone_number": "208-359-2101",
            "fax_number": "208-356-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUFT",
        "first_name": "ANNETTE",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "58901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.