Robin Amber Nettleton, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

63043 Issued in ID

Practice address

840 N 4TH E
Mountain Home, ID 83647-2166

Phone

(208) 587-1850

Fax

(208) 587-1851

NPI assigned

Nov 16, 2019

Last updated

Nov 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573862400000",
    "number": "1336784081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7056 W ROCKING Y LN",
            "city": "GLENNS FERRY",
            "state": "ID",
            "postal_code": "836235029",
            "telephone_number": "218-838-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N 4TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472166",
            "telephone_number": "208-587-1850",
            "fax_number": "208-587-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "ROBIN",
        "middle_name": "AMBER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "63043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Home Physical Therapy, PC
• Mountain Home School District 193
• Timothy James Muhonen, MD
• Vernon T Mullins, MSN, APRN, FNP-BC
• Maria Buena Musacchio
• Thanh-Truc Nguyen
• Allison Noland
• Norris Eye Care LLC (Mountain Home Eye Center)
• Jonathan Paul Norris, O.D.
• North Canyon Mountain Home Clinic

• Family Nurse Practitioner in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.