Individual provider Active NPI

Jennifer L Nordquist, NP

  • Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1437489895
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
N28446 Issued in ID
Practice address
1525 E Leighfield Dr
Ste 150
Meridian, ID 83646-5371
Phone
(208) 888-1199
Fax
(208) 888-0807
NPI assigned
Jan 7, 2010
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X N28446 ID Primary

Addresses

Primary practice location

1525 E Leighfield Dr
Ste 150
Meridian, ID 83646-5371

Mailing address

1525 E Leighfield Dr
Ste 150
Meridian, ID 83646-5371
Phone (208) 888-1199

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
I20100304000888 ID Practitioner - Nurse Practitioner 1557406394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N28446IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Nurse Practitioner Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 4, 2013 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 4, 2013 Accepting new patients
David J Butuk MD PA PastSince Nov 1, 2003 Accepting new patients
Idaho Emergency Physicians, P.a. PastSince Dec 1, 2011 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3217 W Bavaria St
Eagle, ID 83616
Phone (208) 286-6676

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

Interoperability endpoints

  • Direct secure messaging: jnordquist1564097@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1437489895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E LEIGHFIELD DR",
            "address_2": "STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465371",
            "telephone_number": "208-888-1199",
            "fax_number": "208-888-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E LEIGHFIELD DR",
            "address_2": "STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465371",
            "telephone_number": "208-888-1199",
            "fax_number": "208-888-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDQUIST",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N28446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.