Individual provider Active NPI

Michael Pinkerton, MFT

  • Marriage & Family Therapist
  • Boise, ID
National Provider Identifier
1417016288
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
12335 N Humphreys Way
Boise, ID 83714-9304
Phone
(707) 708-1644
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 29295 CA
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

12335 N Humphreys Way
Boise, ID 83714-9304

Mailing address

12335 N Humphreys Way
Boise, ID 83714-9304
Phone (707) 708-1644

Other practice location 1

2 Padre Pkwy Ste 302
Rohnert Park, CA 94928-2116
Phone (707) 708-1644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250320002985 ID Practitioner - Marriage and Family Therapist 2769586742 Practice locations: Boise, ID
I20250519000479 CA Practitioner - Marriage and Family Therapist 2769586742 Practice locations: Rohnert Park, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1417016288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12335 N HUMPHREYS WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149304",
            "telephone_number": "707-708-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12335 N HUMPHREYS WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149304",
            "telephone_number": "707-708-1644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Padre Pkwy Ste 302",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282116",
            "country_code": "US",
            "telephone_number": "707-708-1644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINKERTON",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29295",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.