Active NPI
Timothy Mavy
- Hearing Instrument Specialist
- Boise, ID
National Provider Identifier
1275940108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HA-3643
- Practice address
- 5513 N Glenwood St
Boise, ID 83714-1334 - Phone
- (208) 375-6600
- Fax
- (208) 375-7558
- NPI assigned
- Jul 11, 2014
- Last updated
- Jan 19, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HA-3643 | ID | Primary |
Addresses
Primary practice location
5513 N Glenwood St
Boise, ID 83714-1334
Mailing address
5513 N Glenwood St
Boise, ID 83714-1334
Phone (208) 375-6600
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HA-3643 | ID | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amplify Group LLC | Past | Accepting new patients | |
| Matthew S. Murphy | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba House of Hearing Audiology Clinic
- Hearing and Speech Clinic/Center
- Boise, ID
- NPI 1215651120
-
dba House of Hearing Audiology Clinic
- Audiologist-Hearing Aid Fitter
- Boise, ID
- NPI 1538816913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1275940108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5513 N GLENWOOD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837141334",
"telephone_number": "208-375-6600",
"fax_number": "208-375-7558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5513 N GLENWOOD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837141334",
"telephone_number": "208-375-6600",
"fax_number": "208-375-7558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVY",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-11",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "ID",
"license": "HA-3643",
"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 Jan 19, 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.