Individual provider Active NPI

Stephanie Brooke Hodson, MD

  • Hematology & Oncology Physician
  • Meridian, ID
National Provider Identifier
1265478374
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
M-8633 Issued in ID
Practice address
2855 E Magic View Dr
Meridian, ID 83642-6245
Phone
(208) 888-8209
Fax
(208) 888-8211
NPI assigned
Jun 20, 2006
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X M8633 ID
Hematology & Oncology Physician 207RH0003X M-8633 ID Primary

Addresses

Primary practice location

2855 E Magic View Dr
Meridian, ID 83642-6245

Mailing address

127 W Horizon Cir
Boise, ID 83702-4455
Phone (208) 891-6640

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-8633IDMDHematology & Oncology Physician
M8633IDMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Kos MD, PS Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1265478374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W HORIZON CIR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024455",
            "telephone_number": "208-891-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 E MAGIC VIEW DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426245",
            "telephone_number": "208-888-8209",
            "fax_number": "208-888-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODSON",
        "first_name": "STEPHANIE",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "M8633",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "M-8633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.