Individual provider Active NPI

Seana Peterie, FNP-C

  • Family Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1376373993
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1961871 Issued in ID
Practice address
1375 N Happy Valley Rd
Nampa, ID 83687-5280
Phone
(208) 809-2869
Fax
(208) 809-2870
NPI assigned
Aug 7, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1961871 ID Primary
Registered Nurse 163W00000X 43521 ID

Addresses

Primary practice location

1375 N Happy Valley Rd
Nampa, ID 83687-5280

Mailing address

1375 N Happy Valley Rd
Nampa, ID 83687-5280
Phone (208) 809-2869

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241212004092 ID Practitioner - Nurse Practitioner 9931635943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

1900 W Chinden Blvd
Meridian, ID 83646-6690
Phone (208) 809-2860

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43521IDMDRegistered Nurse
1961871IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Family Medicine CurrentSince Jan 6, 2025 Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince Jan 6, 2025 Accepting new patients
Alliance Medical Group, LLC Family Medicine Past Accepting new patients

Locations

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

1900 W Chinden Blvd
Meridian, ID 83646
Phone (208) 809-2860

1375 N Happy Valley Rd
Nampa, ID 83687
Phone (208) 809-2869

Interoperability endpoints

  • Direct secure messaging: seana.peterie@phmg.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1376373993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 N HAPPY VALLEY RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875280",
            "telephone_number": "208-809-2869",
            "fax_number": "208-809-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N HAPPY VALLEY RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875280",
            "telephone_number": "208-809-2869",
            "fax_number": "208-809-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERIE",
        "first_name": "SEANA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "1961871",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "43521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.