Individual provider Active NPI

Monica Vernon, PA

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1386192102
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1412 Issued in ID
Practice address
11035 Karcher Rd
Nampa, ID 83651
Phone
(208) 302-6600
Fax
(208) 302-6655
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1412 ID Primary

Addresses

Primary practice location

11035 Karcher Rd
Nampa, ID 83651

Mailing address

910 NW 16TH St
Fruitland, ID 83619-2265
Phone (208) 302-6600

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
I20161026002764 ID Practitioner - Physician Assistant 6608154653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jonathan Barrus DO PCGroup PAC ID 8729489620, 5 clinicians
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

2020 S Johns Ave
Suite B
Emmett, ID 83617-9410
Phone (208) 369-4340

2310 Gem Ave
Emmett, ID 83617-9625

3025 W Cherry LN
Meridian, ID 83642-8531

867 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 302-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-1412IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 1, 2017 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 1, 2017 Accepting new patients
Hospital Medicine Associates of Idaho PC Physician Assistant Past Accepting new patients

Locations

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

910 NW 16th St
Fruitland, ID 83619
Phone 2084523111100

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

11035 W Karcher Rd
Nampa, ID 83651
Phone (208) 302-6600

1050 SW 3rd Ave
Ste 1600
Ontario, OR 97914
Phone (541) 881-2360

Interoperability endpoints

  • Direct secure messaging: monica.vernon.1@23758.direct.athenahealth.com
  • Direct secure messaging: mvernon1564276@direct.trinity-health.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598054400000",
    "number": "1386192102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NW 16TH ST",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192265",
            "telephone_number": "208-302-6600",
            "fax_number": "208-302-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11035 KARCHER RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83651",
            "telephone_number": "208-302-6600",
            "fax_number": "208-302-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "MONICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2020-08-22",
        "certification_date": "2020-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.