NPIMap

Organization Active NPI

Bella Family Healthcare & Aesthetics

  • Primary Care Clinic/Center
  • Meridian, ID
National Provider Identifier
1275186835
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BELLA FAMILY HEALTHCARE & AESTHETICS
Practice address
1545 E Leighfield Dr Ste 100
Meridian, ID 83646-5371
Phone
(208) 957-6871
Fax
(208) 957-6872
NPI assigned
Jul 22, 2019
Last updated
Jul 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Authorized official

Name
Suzanne Jardine, NPNPI 1306390380
Title
NP, Owner
Phone
(208) 957-6871

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1545 E Leighfield Dr Ste 100
Meridian, ID 83646-5371

Mailing address

1545 E Leighfield Dr Ste 100
Meridian, ID 83646-5371
Phone (208) 957-6871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200207001016 ID Part B Supplier - Clinic/Group Practice 1850727983 Receives reassigned benefits from 2 practitioners
Practice locations: Meridian, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2172574Bella Family Healthcare & Aesthetics LLC1545 Leighfield Ste 100, Meridian, ID 83646Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory

Locations

1545 E Leigh Field Dr
Ste 100
Meridian, ID 83646

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1275186835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 E LEIGHFIELD DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465371",
            "telephone_number": "208-957-6871",
            "fax_number": "208-957-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E LEIGHFIELD DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465371",
            "telephone_number": "208-957-6871",
            "fax_number": "208-957-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA FAMILY HEALTHCARE & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "JARDINE",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "NP, OWNER",
        "authorized_official_telephone_number": "208-957-6871",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.