Active NPI
Johnny Garcia, CST
- Surgical Assistant
- Boise, ID
National Provider Identifier
1366263618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 189048
- Practice address
- 8800 W Emerald St
Boise, ID 83704-8205 - Phone
- (208) 373-5000
- NPI assigned
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 189048 | ID | Primary |
Addresses
Primary practice location
8800 W Emerald St
Boise, ID 83704-8205
Mailing address
10422A W Glen Ellyn CT
Boise, ID 83704-5440
Phone (208) 761-1239
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
| License | State | Type | Specialty |
|---|---|---|---|
| 189048 | ID | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1366263618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10422A W GLEN ELLYN CT",
"city": "BOISE",
"state": "ID",
"postal_code": "837045440",
"telephone_number": "208-761-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8800 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837048205",
"telephone_number": "208-373-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "JOHNNY",
"credential": "CST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-21",
"certification_date": "2024-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "ID",
"license": "189048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.