NPIMap

Individual provider Active NPI

Brooke Pearson, NP-C

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1457500332
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP1507A Issued in ID
Practice address
5610 W Gage St
Boise, ID 83706-1349
Phone
(208) 501-8955
Fax
(208) 370-3382
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP1507A ID Primary

Addresses

Primary practice location

5610 W Gage St
Boise, ID 83706-1349

Mailing address

45640 Schoenherr Rd Ste B
Shelby Township, MI 48315-6033
Phone (586) 247-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150422000509 ID Practitioner - Nurse Practitioner 5496971996 Reassigns benefits to 1 organization
I20151124001964 OR Practitioner - Nurse Practitioner 5496971996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clair Specialty Physicians PCGroup PAC ID 6204733256, 36 clinicians

Practice addresses (Care Compare)

515 E LN S
Ontario, OR 97914-3953
Phone (208) 501-8955

5610 W Gage St
Suite a
Boise, ID 83706-1332
Phone (208) 367-3370

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Elmore Medical Center Hospital, Mountain Home, ID, CCN 131311
  • Valor Health Hospital, Emmett, ID, CCN 131318
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP1507AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Specialty Physicians PC CurrentSince Jan 4, 2020 Accepting new patients
Idaho Nephrology Associates, L.L.C Past Accepting new patients

Locations

5610 W Gage St
Ste A
Boise, ID 83706
Phone (208) 367-3370

45640 Schoenherr Rd
Ste B
Utica, MI 48315
Phone (586) 247-4300

45640 Schoenherr Rd
Utica, MI 48315
Phone (586) 247-4300

515 East Ln S
Ontario, OR 97914
Phone (208) 501-8955

Interoperability endpoints

  • Direct secure messaging: brookepearson@stclairspe.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1457500332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45640 SCHOENHERR RD STE B",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "586-247-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061349",
            "telephone_number": "208-501-8955",
            "fax_number": "208-370-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "BROOKE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP1507A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.