Individual provider Active NPI

Joyce Ellen Zimmerman-Golden, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Boise, ID
National Provider Identifier
1316927635
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
63089 Issued in ID
Practice address
1000 E Park Blvd Idaho Center for Reproductive Medicine
Suite 110
Boise, ID 83712
Phone
(208) 342-5900
Fax
(208) 342-2088
NPI assigned
Jan 20, 2006
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 11 AK
Women's Health Nurse Practitioner 363LW0102X 63089 ID Primary

Addresses

Primary practice location

1000 E Park Blvd Idaho Center for Reproductive Medicine
Suite 110
Boise, ID 83712

Mailing address

1000 E Park Blvd Idaho Center for Reproductive Medicine
Suite 110
Boise, ID 83712
Phone (208) 342-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20060816000503 AK Practitioner - Nurse Practitioner 5294738076 Practice locations: Anchorage, AK

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11AKMDWomen's Health Nurse Practitioner
63089IDMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Center for Reproductive Medicine PC PastSince Mar 9, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1316927635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARK BLVD IDAHO CENTER FOR REPRODUCTIVE MEDICINE",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-342-5900",
            "fax_number": "208-342-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARK BLVD IDAHO CENTER FOR REPRODUCTIVE MEDICINE",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-342-5900",
            "fax_number": "208-342-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN-GOLDEN",
        "first_name": "JOYCE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "11",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "63089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.