Active NPI
Judy Davis, RN
- Diabetes Educator Registered Nurse
- Boise, ID
National Provider Identifier
1255459798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- N-18690
- Practice address
- 11194 W Highmont Dr
Boise, ID 83709-7703 - Phone
- (208) 376-3446
- NPI assigned
- Mar 26, 2007
- Last updated
- Mar 25, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | N-18690 | ID | Primary |
Addresses
Primary practice location
11194 W Highmont Dr
Boise, ID 83709-7703
Mailing address
11194 W Highmont Dr
Boise, ID 83709-7703
Phone (208) 376-3446
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-18690 | ID | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364169600000",
"number": "1255459798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11194 W HIGHMONT DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837097703",
"telephone_number": "208-376-3446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11194 W HIGHMONT DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837097703",
"telephone_number": "208-376-3446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JUDY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2013-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "ID",
"license": "N-18690",
"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 Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.