NPIMap

Individual provider Active NPI

Amy Dancer, NP

  • Family Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1407214497
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1707A Issued in ID
Practice address
2347 E Gala St
Meridian, ID 83642-4881
Phone
(208) 323-3676
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X N-31964 ID
Family Nurse Practitioner 363LF0000X NP-1707A ID Primary

Addresses

Primary practice location

2347 E Gala St
Meridian, ID 83642-4881

Mailing address

2347 E Gala St
Meridian, ID 83642-4881
Phone (208) 323-3676

Other names 1

  • Amy Woods Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001626 ID Practitioner - Nurse Practitioner 3971800947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keystone Center for Geriatrics LLCGroup PAC ID 7618365792, 8 clinicians

Practice addresses (Care Compare)

1139 E Winding Creek Dr
Eagle, ID 83616-7232
Phone (208) 963-1034

Hospital & facility affiliations

  • First Choice Home Care Home health agency, Boise, ID, CCN 137108
  • Horizon Home Health Home health agency, Meridian, ID, CCN 137065
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N-31964IDMDRegistered Nurse
NP-1707AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Center for Geriatrics LLC CurrentSince Nov 1, 2021 Accepting new patients
Marion Luque,PLLC CurrentSince Nov 1, 2021 Accepting new patients
Key Stone Health Care CurrentSince Feb 1, 2018 Accepting new patients
Keystone Hospice, LLC PastSince Aug 11, 2019 Accepting new patients

Locations

305 W Bannock St
Boise, ID 83702
Phone (208) 514-0670

1139 E Winding Creek Dr
Eagle, ID 83616
Phone (208) 938-8887

21 N Fisher Park Way
Eagle, ID 83616
Phone (208) 514-0670

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1407214497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 E GALA ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424881",
            "telephone_number": "208-323-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 E GALA ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424881",
            "telephone_number": "208-323-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCER",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N-31964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1707A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WOODS",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.