Individual provider Active NPI

John W. Hanks, DO

  • Pediatrics Physician
  • Meridian, ID
National Provider Identifier
1396794665
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
O-169 Issued in ID
Practice address
1620 S Celebration Ave
Meridian, ID 83642-2779
Phone
(208) 884-1030
Fax
(208) 884-3058
NPI assigned
May 6, 2006
Last updated
Aug 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X O-169 ID Primary

Addresses

Primary practice location

1620 S Celebration Ave
Meridian, ID 83642-2779

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince Nov 1, 2011 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1620 S Celebration Ave
Meridian, ID 83642
Phone (208) 884-1030

Interoperability endpoints

  • Direct secure messaging: jhanks1780@direct.slhs.org

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, 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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1396794665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S CELEBRATION AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422779",
            "telephone_number": "208-884-1030",
            "fax_number": "208-884-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKS",
        "first_name": "JOHN",
        "middle_name": "W.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "O-169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.