Individual provider Active NPI

Mendy Williams

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1366976151
Registry record updated Feb 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55935 Issued in ID
Practice address
338 E Bannock St
Boise, ID 83712-6207
Phone
(208) 336-0895
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 55935 ID Primary

Addresses

Primary practice location

338 E Bannock St
Boise, ID 83712-6207

Mailing address

338 E Bannock St
Boise, ID 83712-6207
Phone (208) 336-0895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016000958 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840566030 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Anesthesia Associates of Boise, P.a.Group PAC ID 2668385287, 183 clinicians
Access Anesthesia LLCGroup PAC ID 5193019230, 3 clinicians

Practice addresses (Care Compare)

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

3630 E Louise Dr
Meridian, ID 83642-7975
Phone (208) 377-9515

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
55935IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tree City Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2024 Accepting new patients
Access Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2024 Accepting new patients
Anesthesia Associates of Boise, P.a. CurrentSince Aug 19, 2017 Accepting new patients

Locations

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

811 N Liberty St
Boise, ID 83704
Phone (208) 323-4522

1000 State St
McCall, ID 83638
Phone (208) 634-2221

3630 E Louise Dr
Meridian, ID 83642
Phone (208) 377-9515

1209 N Summerbrook Ave
Ste 100
Meridian, ID 83642
Phone (208) 296-6586

3085 E Magic View Dr
Ste 140
Meridian, ID 83642
Phone (208) 229-9009

3071 E Franklin Rd
Ste 101
Meridian, ID 83642
Phone (208) 288-1400

Organizations & group practices 3

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 2

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708214400000",
    "number": "1366976151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126207",
            "telephone_number": "208-336-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126207",
            "telephone_number": "208-336-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MENDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2024-02-18",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "55935",
            "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 Feb 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.