Organization Active NPI

Abundant Life Health Care PC

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1386750552
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-541A Issued in ID
Legal business name
ABUNDANT LIFE HEALTH CARE PC
Practice address
1617 W Jefferson St
Boise, ID 83702-5111
Phone
(208) 433-9188
Fax
(208) 433-9372
NPI assigned
Aug 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
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

Authorized official

Name
Karole L Beck, FNPNPI 1467565317
Title
Family Nurse Practitioner
Phone
(208) 433-9188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X NP-541A ID Primary

Addresses

Primary practice location

1617 W Jefferson St
Boise, ID 83702-5111

Mailing address

1617 W Jefferson St
Boise, ID 83702-5111
Phone (208) 433-9188

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386750552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 W JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025111",
            "telephone_number": "208-433-9188",
            "fax_number": "208-433-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 W JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025111",
            "telephone_number": "208-433-9188",
            "fax_number": "208-433-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE HEALTH CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "KAROLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "208-433-9188",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-541A",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.