NPIMap

Individual provider Active NPI

Shawn Christian Nowierski, MD

  • Family Medicine Physician
  • Eagle, ID
National Provider Identifier
1437109089
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M7050 Issued in ID
Practice address
197 W State St
Eagle, ID 83616-4959
Phone
(208) 938-9817
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M7050 ID Primary

Addresses

Primary practice location

197 W State St
Eagle, ID 83616-4959

Mailing address

932 Hearthstone Dr
Boise, ID 83702-1826
Phone (208) 331-9358

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
I20040602000360 ID Practitioner - Family Practice 5799767034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

323 E Riverside Dr
Suite 136
Eagle, ID 83616-6865
Phone (208) 939-3197

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions149
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M7050IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Family Medicine P a Family Medicine CurrentSince Jul 3, 2006 Accepting new patients

Locations

100 Cottonwood Ct
#100
Eagle, ID 83616
Phone (208) 939-3197

323 E Riverside Dr
Ste 136
Eagle, ID 83616
Phone (208) 939-2939

Organizations & group practices 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1437109089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 HEARTHSTONE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837021826",
            "telephone_number": "208-331-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 W STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164959",
            "telephone_number": "208-938-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWIERSKI",
        "first_name": "SHAWN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M7050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.