Individual provider Active NPI

Eric Fast, FNP

  • Primary Care Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1376918383
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP-1692A Issued in ID
Practice address
191 Addison Ave
Twin Falls, ID 83301-5177
Phone
(208) 944-0369
NPI assigned
Dec 2, 2015
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60627369 WA
Nurse Practitioner 363L00000X NP-1692A ID
Primary Care Nurse Practitioner 363LP2300X NP-1692A ID Primary

Addresses

Primary practice location

191 Addison Ave
Twin Falls, ID 83301-5177

Mailing address

191 Addison Ave
Twin Falls, ID 83301-5177
Phone (208) 944-0369

Other identifiers 1

IdentifierTypeStateIssuer
1376918383OtherIDIPN-IDAHO PHYSICIANS NETWORK

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
I20160302001489 ID Practitioner - Nurse Practitioner 1557667466 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
All About You Hormones and Wellness, PLLC Current Accepting new patients
Molina Care Connections, LLC. Nurse Practitioner CurrentSince May 3, 2021 Accepting new patients
Urgent Care of Idaho, LLC CurrentSince Oct 22, 2022 Accepting new patients
River View Urgent Care & Medical Center Inc CurrentSince Oct 22, 2022 Accepting new patients
Urgent Care of Idaho, LLC CurrentSince Oct 22, 2022 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

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

382 N Overland Ave
Burley, ID 83318
Phone (208) 378-7700

191 Addison Ave
Twin Falls, ID 83301
Phone (208) 732-0700

2392 Addison Ave E
Twin Falls, ID 83301
Phone (208) 933-2050

Organizations & group practices 5

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": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1376918383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 ADDISON AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015177",
            "telephone_number": "208-944-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 ADDISON AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015177",
            "telephone_number": "208-944-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "ERIC",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-02",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60627369",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-1692A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "NP-1692A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IPN-IDAHO PHYSICIANS NETWORK",
            "identifier": "1376918383",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.