NPIMap

Organization Active NPI

Family and Adolescent Care of Twin Falls PA

  • Family Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1477816809
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-986A Issued in ID
Legal business name
FAMILY AND ADOLESCENT CARE OF TWIN FALLS PA
Practice address
476 Cheney Drive West
Suite 160
Twin Falls, ID 83301
Phone
(208) 944-0497
Fax
(208) 944-0506
NPI assigned
Jun 20, 2012
Last updated
Aug 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Authorized official

Name
Roanne Mancari, NP-CNPI 1922329416
Title
Owner
Phone
(208) 731-6971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X NP-986A ID Primary

Addresses

Primary practice location

476 Cheney Drive West
Suite 160
Twin Falls, ID 83301

Mailing address

476 Cheney Drive West
Suite 160
Twin Falls, ID 83301
Phone (208) 944-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120802000512 ID Part B Supplier - Clinic/Group Practice 1759537038 Receives reassigned benefits from 7 practitioners
Practice locations: Twin Falls, ID

National Provider Directory

National Provider Directory

Locations

1385 Park View Dr
Ste 101
Twin Falls, ID 83301
Phone (208) 944-0497

476 Cheney Dr W
Ste 160
Twin Falls, ID 83301
Phone (208) 358-2012

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1477816809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 CHENEY DRIVE WEST",
            "address_2": "SUITE 160",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-944-0497",
            "fax_number": "208-944-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 CHENEY DRIVE WEST",
            "address_2": "SUITE 160",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-944-0497",
            "fax_number": "208-944-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND ADOLESCENT CARE OF TWIN FALLS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "MANCARI",
        "authorized_official_first_name": "ROANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-731-6971",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-986A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.