West Boise Wellness Center

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

WEST BOISE WELLNESS CENTER

Practice address

2427 N Cole Rd
Boise, ID 83704-5907

Phone

(208) 639-1855

NPI assigned

Jul 3, 2023

Organization subpart

No

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

Authorized official

Name

Susan Boise

Title

Owner

Phone

(208) 731-8169

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1265119093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045907",
            "telephone_number": "208-639-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BOISE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "BOISE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-731-8169"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.