NPIMap

Organization Active NPI

Division of Veterans Services

  • Skilled Nursing Facility
  • Boise, ID
National Provider Identifier
1285624627
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
93 Issued in ID
Legal business name
DIVISION OF VETERANS SERVICES
Practice address
320 Collins Rd
Boise, ID 83702-4519
Phone
(208) 780-1600
Fax
(208) 780-1601
NPI assigned
Oct 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Tracy Schaner
Title
Deputy Chief Administrator
Phone
(208) 780-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 93 ID Primary

Addresses

Primary practice location

320 Collins Rd
Boise, ID 83702-4519

Mailing address

320 Collins Rd
Boise, ID 83702-4519
Phone (208) 334-5000

Other identifiers 5

IdentifierTypeStateIssuer
93OtherIDNURSING FACILITY LICENSE
1307176OtherIDNCPDP
1639HPOtherIDPHARMACY LICENSE
8058337MedicaidID
135131OtherIDMEDICARE/OSCAR

Other names 1

  • Idaho State Veterans Home - Boise Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070507000241 ID Part A Provider - Skilled Nursing Facility 5698871762 Practice locations: Boise, ID

Skilled nursing facility certification: CCN 135131

Legal name
DIVISION OF VETERANS SERVICES
Doing business as
IDAHO STATE VETERANS HOME-BOISE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 2007
Last certification
May 16, 2025
Beds
122
Ownership / control type
State
Multi-facility organization
Idaho Division of Veterans Services
Organization structure
GovernmentNon-profit
Incorporated
May 1, 1895 in ID
Enrollment address
320 N Collins Rd
Boise, ID 83702-4519
Nursing home name
IDAHO STATE VETERANS HOME - BOISE

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Idaho State Veterans Home - BoiseCCN 135131 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Sep 1, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12275.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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
13D0890001Idaho State Veterans Home Boise320 Collins Rd, Boise, ID 83702Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory
Tax ID family
Division of Veterans Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ricky Holloway Individual W-2 Managing Employee Jun 9, 2016
Division of Veterans Services Organization, Boise, ID 5% Or Greater Direct Ownership Interest Jul 1, 2000 100%
Operational/Managerial Control Jan 1, 2006

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Idaho State Veterans Home LewistonLewiston, ID, CCN 135133 Skilled nursing facility Other (100%) Jan 1, 2006
Idaho State Veterans Home - PocatelloPocatello, ID, CCN 135132 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 18, 1992
Mar 26, 2007
Idaho State Veterans Home - Post FallsPost Falls, ID, CCN 135148 Skilled nursing facility Operational/Managerial Control (100%) Jul 1, 2018

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1285624627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 COLLINS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024519",
            "telephone_number": "208-334-5000",
            "fax_number": "208-334-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 COLLINS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024519",
            "telephone_number": "208-780-1600",
            "fax_number": "208-780-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVISION OF VETERANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "SCHANER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DEPUTY CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "208-780-1320"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "93",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING FACILITY LICENSE",
            "identifier": "93",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1307176",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "1639HP",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8058337",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/OSCAR",
            "identifier": "135131",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho State Veterans Home - Boise",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Idaho State Veterans Home - Boise",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.