Individual provider Active NPI

Tamra Katherine Geryk, FNP-C

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1487220380
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
55636 Issued in ID
Practice address
4280 N Ginzel St
Boise, ID 83703-4214
Phone
(413) 687-3027
Fax
(208) 254-4895
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 55636 ID Primary

Addresses

Primary practice location

4280 N Ginzel St
Boise, ID 83703-4214

Mailing address

4280 N Ginzel St
Boise, ID 83703-4214
Phone (307) 690-4748

Other practice location 1

2939 W Excursion Ln
Meridian, ID 83642-5308
Phone (208) 385-7711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2025 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deva Wellness PLLC Family CurrentSince Jun 30, 2024 Accepting new patients
Functional Medicine of Idaho PC PastSince Jun 1, 2021 Accepting new patients
Saint Alphonsus Regional Medical Center Inc PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1487220380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 N GINZEL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837034214",
            "telephone_number": "307-690-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 N GINZEL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837034214",
            "telephone_number": "413-687-3027",
            "fax_number": "208-254-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2939 W Excursion Ln",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836425308",
            "country_code": "US",
            "telephone_number": "208-385-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERYK",
        "first_name": "TAMRA",
        "middle_name": "KATHERINE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "55636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.