Regional Physician Services of Idaho, PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REGIONAL PHYSICIAN SERVICES OF IDAHO, PC

Practice address

1105 2ND St S Ste 100
Nampa, ID 83651-3911

Phone

(480) 862-1677

Fax

(480) 718-7643

NPI assigned

Apr 4, 2011

Organization subpart

No

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

Authorized official

Name

Victoria Alvarez

Title

Director, Credentialing

Phone

(480) 862-1695

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1417246158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW #220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585172",
            "telephone_number": "480-862-1700",
            "fax_number": "877-506-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 2ND ST S STE 100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513911",
            "telephone_number": "480-862-1677",
            "fax_number": "480-718-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL PHYSICIAN SERVICES OF IDAHO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "480-862-1695"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.