Individual provider Active NPI

Tricia A Beveridge-Choo, NP

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1295053189
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-974A Issued in ID
Practice address
100 E Idaho St
Ste 300
Boise, ID 83712-6267
Phone
(208) 381-7370
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21529A ID
Family Nurse Practitioner 363LF0000X NP-974A ID Primary

Addresses

Primary practice location

100 E Idaho St
Ste 300
Boise, ID 83712-6267

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 706-8449

Other names 1

  • Tricia Beveridge Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000333 ID Practitioner - Nurse Practitioner 3274722996 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21529AIDMDFamily Nurse Practitioner
NP-974AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince Jul 15, 2013 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince Jul 15, 2013 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

100 E Idaho St
Ste 300
Boise, ID 83712
Phone (208) 345-5400

305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: tbeveridgechoo18686@direct.slhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1295053189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-706-8449",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "address_2": "STE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126267",
            "telephone_number": "208-381-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERIDGE-CHOO",
        "first_name": "TRICIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "21529A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-974A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "BEVERIDGE",
            "credential": "NP.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.