Jill Elizabeth Boatman, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

70913 Issued in ID

Practice address

190 E Bannock St
Boise, ID 83712-6241

Phone

(208) 381-2074

NPI assigned

Dec 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Elizabeth Rolfson Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Access Behavioral Health Services

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1487700589
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• Access Behavioral Health Services, Inc

  • Primary Care Clinic/Center
  • Boise, ID
  • NPI 1932506508
  NPD

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1487314423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 SW 4th Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OR",
            "postal_code": "979142638",
            "country_code": "US",
            "telephone_number": "541-889-2668",
            "fax_number": "541-889-2997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOATMAN",
        "first_name": "JILL",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "70913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "ROLFSON",
            "middle_name": "ELIZABETH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell Eric Blume, PA-C, RD, CDE
• Larue Antoine Bluth, D.M.D.
• Desiree Ann Blythe, LPC, MS, NCC
• Kerriann Boanca, MD
• Rd Boardman, LPC
• Renee A Bobrowski, MD
• Andrea L Bockenstette, NP
• Joshua Charles Bode, LCSW
• Rachael A Bodes, MD
• Stephanie Bodes, MD

• Pediatric Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.