Active NPI
Jayne Stevenson, M.D.
- Legal Medicine
- Boise, ID
National Provider Identifier
1285779496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- M8899
- Practice address
- 802 W Bannock St
Suite 405
Boise, ID 83702-5837 - Phone
- (208) 336-7341
- Fax
- (208) 336-7342
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Legal Medicine | 173000000X | M8899 | ID | Primary |
Addresses
Primary practice location
802 W Bannock St
Suite 405
Boise, ID 83702-5837
Mailing address
802 W Bannock St
Suite 405
Boise, ID 83702-5837
Phone (208) 336-7341
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010147087 | Other | ID | REGENCE BLUE SHIELD |
| 75739 | Other | ID | BLUE CROSS OF IDAHO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| M8899 | ID | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Horizons Inc | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Boise, ID
- NPI 1285767574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285779496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 W BANNOCK ST",
"address_2": "SUITE 405",
"city": "BOISE",
"state": "ID",
"postal_code": "837025837",
"telephone_number": "208-336-7341",
"fax_number": "208-336-7342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 W BANNOCK ST",
"address_2": "SUITE 405",
"city": "BOISE",
"state": "ID",
"postal_code": "837025837",
"telephone_number": "208-336-7341",
"fax_number": "208-336-7342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "JAYNE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "ID",
"license": "M8899",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "000010147087",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "75739",
"state": "ID"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.