Individual provider Active NPI

Tonya Jean Jenott, NP

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1467072660
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
64546 Issued in ID
Practice address
420 W Main St Ste 206
Boise, ID 83702-7363
Phone
(208) 426-9200
Fax
(208) 426-9300
NPI assigned
Apr 17, 2020
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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 64546 ID Primary

Addresses

Primary practice location

420 W Main St Ste 206
Boise, ID 83702-7363

Mailing address

11434 W Montana St
Boise, ID 83713-1130
Phone (208) 724-4006

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
I20210325001343 ID Practitioner - Nurse Practitioner 7214344951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64546IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Meridian Advanced Psychiatry , LLC CurrentSince Dec 11, 2020 Accepting new patients
Medical Directors of Idaho PLLC Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Elevate Health Group PLLC CurrentSince Apr 19, 2020 Accepting new patients
Bella Family Healthcare & Aesthetics PastSince Dec 14, 2019 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

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

420 W Main St
Ste 206
Boise, ID 83702
Phone (208) 343-2770

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

909 E Reserve St
Boise, ID 83712
Phone (208) 343-7717

1672 S Woodsage Ave
Ste 120
Meridian, ID 83642
Phone (208) 515-2273

3525 E Louise Dr
Ste 195
Meridian, ID 83642

3525 E Louise Dr
Ste 255
Meridian, ID 83642
Phone (208) 489-5099

Organizations & group practices 6

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": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1467072660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11434 W MONTANA ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131130",
            "telephone_number": "208-724-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAIN ST STE 206",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027363",
            "telephone_number": "208-426-9200",
            "fax_number": "208-426-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENOTT",
        "first_name": "TONYA",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "64546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.