Individual provider Active NPI

Alexandria W. Mwanga, DNP, FNP-C

  • Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1336815562
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
69372 Issued in ID
Practice address
2321 E Gala St Ste 3
Meridian, ID 83642-7692
Phone
(208) 888-5848
Fax
(208) 888-0884
NPI assigned
Aug 18, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X 69372 ID
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 69372 ID
General Practice Physician 208D00000X 69372 ID
Hospitalist Physician 208M00000X 69372 ID
Nurse Practitioner 363L00000X 69372 ID Primary

Addresses

Primary practice location

2321 E Gala St Ste 3
Meridian, ID 83642-7692

Mailing address

1965 S Eagle Rd Ste 180
Meridian, ID 83642-9246
Phone (986) 666-3866

Other practice location 1

1965 S Eagle Rd Ste 180
Meridian, ID 83642-9246
Phone (986) 666-3866

Other practice location 2

303 N Allumbaugh St Ste 335
Boise, ID 83704-9208
Phone (208) 888-5848

Other names 1

  • Andy Mwanga Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220317000466 ID Practitioner - Nurse Practitioner 7517352180 Reassigns benefits to 2 organizations
I20260309002297 UT Practitioner - Nurse Practitioner 7517352180 Reassigns benefits to 1 organization
I20260309002531 WA Practitioner - Nurse Practitioner 7517352180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midvalley Healthcare PLLCGroup PAC ID 0749327880, 17 clinicians

Practice addresses (Care Compare)

2321 E Gala St
Suite 3
Meridian, ID 83642-7692
Phone (208) 888-5848

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69372IDMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Healthcare LLC Health & Wellness Coach CurrentSince Dec 22, 2024 Accepting new patients
Signify Health, LLC Multi-Specialty CurrentSince Jan 12, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Multi-Specialty CurrentSince Feb 1, 2026 Accepting new patients
Midvalley Healthcare PLLC Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients

Locations

303 N Allumbaugh St
Ste 335
Boise, ID 83704
Phone (208) 888-5848

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

2321 E Gala St
Ste 3
Meridian, ID 83642
Phone (208) 288-2280

1965 S Eagle Rd
Ste 180
Meridian, ID 83642
Phone (208) 288-0649

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHHGDD/Endpoint/HHHGDD

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1336815562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 S EAGLE RD STE 180",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429246",
            "telephone_number": "986-666-3866",
            "fax_number": "986-666-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 E GALA ST STE 3",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427692",
            "telephone_number": "208-888-5848",
            "fax_number": "208-888-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1965 S Eagle Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836429246",
            "country_code": "US",
            "telephone_number": "986-666-3866",
            "fax_number": "986-666-3038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 N Allumbaugh St Ste 335",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049208",
            "country_code": "US",
            "telephone_number": "208-888-5848",
            "fax_number": "208-888-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANGA",
        "first_name": "ALEXANDRIA",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": "ID",
            "license": "69372",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "69372",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "69372",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "69372",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "69372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "MWANGA",
            "credential": "DNP, FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.