Active NPI
Cynthia Ray Culp, FNP
- Family Nurse Practitioner
- Eagle, ID
National Provider Identifier
1386643146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- N-20880 NP-365
- Practice address
- 951 E Plaza Dr
Suite Number 110
Eagle, ID 83616-6566 - Phone
- (208) 938-5680
- Fax
- (208) 938-5679
- NPI assigned
- Jul 14, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | N-20880 NP-365 | ID | Primary |
Addresses
Primary practice location
951 E Plaza Dr
Suite Number 110
Eagle, ID 83616-6566
Mailing address
1199 N Macaile Way
Eagle, ID 83616-6919
Phone (208) 938-5680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805112500 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-20880 NP-365 | ID | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1386643146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1199 N MACAILE WAY",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166919",
"telephone_number": "208-938-5680",
"fax_number": "208-938-5679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 E PLAZA DR",
"address_2": "SUITE NUMBER 110",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166566",
"telephone_number": "208-938-5680",
"fax_number": "208-938-5679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULP",
"first_name": "CYNTHIA",
"middle_name": "RAY",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-14",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "N-20880 NP-365",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805112500",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.