Individual provider Active NPI

Jaeger A Ashton, NP

  • Pediatric Nurse Practitioner
  • Boise, ID
National Provider Identifier
1437467644
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN279995 Issued in MA
Practice address
305 E Jefferson St
Boise, ID 83712-6273
Phone
(208) 381-9590
Fax
(208) 381-9599
NPI assigned
Sep 22, 2010
Last updated
Sep 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN279995 MA Primary

Addresses

Primary practice location

305 E Jefferson St
Boise, ID 83712-6273

Mailing address

305 E Jefferson St
Boise, ID 83712-6273
Phone (208) 381-9590

Other practice location 1

1125 Tremont St
Roxbury Crossing, MA 02120-2178
Phone (617) 427-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129002149 ID Practitioner - Nurse Practitioner 0547584146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN279995MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Dec 1, 2014 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1437467644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126273",
            "telephone_number": "208-381-9590",
            "fax_number": "617-989-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126273",
            "telephone_number": "208-381-9590",
            "fax_number": "208-381-9599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Tremont St",
            "address_purpose": "LOCATION",
            "city": "Roxbury Crossing",
            "state": "MA",
            "postal_code": "021202178",
            "country_code": "US",
            "telephone_number": "617-427-1000",
            "fax_number": "617-989-3247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASHTON",
        "first_name": "JAEGER",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN279995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.