Organization Active NPI

Treasure Valley Endocrinology PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Boise, ID
National Provider Identifier
1417967696
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
M 6551 Issued in IL
Legal business name
TREASURE VALLEY ENDOCRINOLOGY PC
Practice address
900 N Liberty St Ste 201
Boise, ID 83704-8707
Phone
(208) 367-6740
Fax
(208) 367-6742
NPI assigned
Aug 9, 2006
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Julie A. Foote, MDNPI 1104836303
Title
Endocrinologist
Phone
(208) 367-6740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M 6551 IL Primary

Addresses

Primary practice location

900 N Liberty St Ste 201
Boise, ID 83704-8707

Mailing address

PO Box 4143
Boise, ID 83711-4143
Phone (208) 367-6740

Other identifiers 1

IdentifierTypeStateIssuer
807326100MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051027000967 ID Part B Supplier - Clinic/Group Practice 0042237117 Receives reassigned benefits from 2 practitioners
Practice locations: Boise, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D1067140Treasure Valley Endocrinology900 N Liberty St #201, Boise, ID 83704Certificate of waiverApr 10, 2027

National Provider Directory

National Provider Directory

Locations

900 N Liberty St
Ste 201
Boise, ID 83704
Phone (208) 367-6740

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1417967696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4143",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837114143",
            "telephone_number": "208-367-6740",
            "fax_number": "208-367-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-367-6740",
            "fax_number": "208-367-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY ENDOCRINOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "FOOTE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ENDOCRINOLOGIST",
        "authorized_official_telephone_number": "208-367-6740",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "M 6551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807326100",
            "state": "ID"
        }
    ],
    "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 Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.