Individual provider Active NPI

David B Talford, PAC

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1396788303
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-262 Issued in ID
Practice address
100 E Warm Springs Ave
Suite a
Boise, ID 83712-6243
Phone
(208) 343-5910
Fax
(208) 384-8562
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-262 ID Primary
Surgical Physician Assistant 363AS0400X PA-262 ID
Medical Physician Assistant 363AM0700X PA-262 ID

Addresses

Primary practice location

100 E Warm Springs Ave
Suite a
Boise, ID 83712-6243

Mailing address

100 E Warm Springs Ave
Suite a
Boise, ID 83712-6243
Phone (208) 343-5910

Other identifiers 1

IdentifierTypeStateIssuer
805455600MedicaidID

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
I20040420001254 ID Practitioner - Physician Assistant 4880680578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
L William D Nowierski MD PAGroup PAC ID 0648394080, 2 clinicians

Practice addresses (Care Compare)

100 E Warm Springs Ave
Suite a
Boise, ID 83712-6243

100 E Warm Springs Ave
Suite a
Boise, ID 83712-6244
Phone (208) 343-5910

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-262IDMDMedical Physician Assistant

Organizations & group practices 1

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1396788303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WARM SPRINGS AVE",
            "address_2": "SUITE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126243",
            "telephone_number": "208-343-5910",
            "fax_number": "208-384-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WARM SPRINGS AVE",
            "address_2": "SUITE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126243",
            "telephone_number": "208-343-5910",
            "fax_number": "208-384-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALFORD",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-262",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-262",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805455600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.