Active NPI
Michael Pinkerton, MFT
- Marriage & Family Therapist
- Boise, ID
National Provider Identifier
1417016288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.