Individual provider Active NPI

James Forrest Fauver

  • Home Health Agency
  • Lewiston, ID
National Provider Identifier
1366195877
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
CFH-9384 Issued in ID
Practice address
24648 Golden LN
Lewiston, ID 83501-7964
Phone
(208) 790-4504
NPI assigned
Feb 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CFH-9384 ID Primary

Addresses

Primary practice location

24648 Golden LN
Lewiston, ID 83501-7964

Mailing address

24648 Golden LN
Lewiston, ID 83501-7964
Phone (208) 790-4504

Other identifiers 1

IdentifierTypeStateIssuer
9384MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CFH-9384IDMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1366195877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24648 GOLDEN LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017964",
            "telephone_number": "208-790-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24648 GOLDEN LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017964",
            "telephone_number": "208-790-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUVER",
        "first_name": "JAMES",
        "middle_name": "FORREST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": "CFH-9384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9384",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.