NPIMap

Individual provider Active NPI

Jessica Sallstrom, DO

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1265967038
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MRO-1637 Issued in ID
Practice address
300 S 23Rd St
Boise, ID 83702-9100
Phone
(208) 344-3512
Fax
(208) 466-5359
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MRO-1637 ID Primary

Addresses

Primary practice location

300 S 23Rd St
Boise, ID 83702-9100

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 467-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201030001145 ID Practitioner - Family Practice 2264702968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

300 S 23Rd St
Boise, ID 83702-9100
Phone (208) 344-3512

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MRO-1637IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. Family Medicine Current Accepting new patients
Community Health Clinics, Inc. CurrentSince Oct 19, 2020 Accepting new patients
Community Health Clinics, Inc. Family Medicine Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Family Medicine Past Accepting new patients

Locations

300 S 23rd St
Boise, ID 83702
Phone (208) 344-3512

400 N Allumbaugh St
Boise, ID 83704
Phone (208) 377-9180

848 S La Cassia Dr
Boise, ID 83705
Phone (208) 344-0086

2005 Arlington Ave
Caldwell, ID 83605
Phone (208) 454-2035

108 E Idaho Ave
Homedale, ID 83628
Phone (208) 337-3189

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

201 S Paradise Ave
Middleton, ID 83644
Phone (208) 585-0048

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

Interoperability endpoints

  • Direct secure messaging: jsallstrom337684@direct.ochin.org
  • Direct secure messaging: jsallstrom@ihrp-id.direct.office.nextgen.com

Organizations & group practices 5

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 7

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1265967038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 23RD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837029100",
            "telephone_number": "208-344-3512",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLSTROM",
        "first_name": "JESSICA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRO-1637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.