Individual provider Active NPI

Cassi E Shelly, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boise, ID
National Provider Identifier
1477994994
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1332A Issued in ID
Practice address
967 E Parkcenter Blvd # 1051
Boise, ID 83706-6721
Phone
(208) 720-9670
NPI assigned
Jul 12, 2013
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP123PEND ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1332A ID Primary

Addresses

Primary practice location

967 E Parkcenter Blvd # 1051
Boise, ID 83706-6721

Mailing address

967 E Parkcenter Blvd # 1051
Boise, ID 83706-6721
Phone (208) 720-9670

Other practice location 1

709 Dearborn St
Caldwell, ID 83605-4116
Phone (208) 376-7083

Other practice location 2

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone (208) 376-7083

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
I20140131000774 ID Practitioner - Nurse Practitioner 8224267869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trivium Life Services Mountain West, LLCGroup PAC ID 2163555053, 4 clinicians

Practice addresses (Care Compare)

12553 W Explorer Dr
Suite 190
Boise, ID 83713-1612
Phone (208) 376-7083

709 Dearborn St
Caldwell, ID 83605-4116
Phone (208) 376-7083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP123PENDIDMDNurse Practitioner
1332AIDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Mind Psychiatry CurrentSince Jul 24, 2022 Accepting new patients
Trivium Life Services Mountain West, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

12553 W Explorer Dr
Ste 190
Boise, ID 83713
Phone (208) 376-7083

709 Dearborn St
Caldwell, ID 83605
Phone (208) 376-7083

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1477994994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 E PARKCENTER BLVD # 1051",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066721",
            "telephone_number": "208-720-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 E PARKCENTER BLVD # 1051",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066721",
            "telephone_number": "208-720-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Dearborn St",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054116",
            "country_code": "US",
            "telephone_number": "208-376-7083",
            "fax_number": "208-321-5069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12553 W Explorer Dr Ste 190",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837131612",
            "country_code": "US",
            "telephone_number": "208-376-7083",
            "fax_number": "208-321-5069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "CASSI",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP123PEND",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "1332A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.