NPIMap

Organization Active NPI

OB-GYN Associates, PA

  • Obstetrics & Gynecology Physician
  • Meridian, ID
National Provider Identifier
1306816079
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OB-GYN ASSOCIATES, PA
Practice address
3520 E. Louise Dr
Meridian, ID 83642
Phone
(208) 955-0350
Fax
(208) 955-0352
NPI assigned
Jan 25, 2006
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Kristi Jo Lynn
Title
Practice Administrator
Phone
(208) 955-0340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3520 E. Louise Dr
Meridian, ID 83642

Mailing address

3520 E. Louise Dr
Meridian, ID 83642
Phone (208) 955-0350

Other identifiers 5

IdentifierTypeStateIssuer
226971MedicaidOR
226972MedicaidOR
89284OtherIDBLUE CROSS; CALDWELL
002415100MedicaidID
8C246OtherIDBLUE CROSS; MERIDIAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000139 ID Part B Supplier - Clinic/Group Practice 4082519467 Receives reassigned benefits from 21 practitioners
Practice locations: Meridian, ID; Nampa, ID; Eagle, ID

National Provider Directory

National Provider Directory

Locations

3101 E State St
Ste 2100
Eagle, ID 83616
Phone (208) 938-2220

3520 E Louise Dr
Meridian, ID 83642
Phone (208) 454-2035

875 S Vanguard Way
Ste 210
Meridian, ID 83642

9850 W St Lukes Dr
#221
Nampa, ID 83687
Phone (208) 455-1784

9850 W St Lukes Dr
Ste 221
Nampa, ID 83687
Phone (208) 593-6340

Practitioners & affiliated clinicians

Practitioners 55

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.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1306816079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 E. LOUISE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-955-0350",
            "fax_number": "208-955-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 E. LOUISE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-955-0350",
            "fax_number": "208-955-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "KRISTI JO",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "208-955-0340"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226971",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226972",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS; CALDWELL",
            "identifier": "89284",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002415100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS; MERIDIAN",
            "identifier": "8C246",
            "state": "ID"
        }
    ],
    "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 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.