Individual provider Active NPI

Camilla Guthrie, NP

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1487322012
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
69138 Issued in ID
Practice address
115 W Main St Ste 101
Boise, ID 83702-7304
Phone
(208) 381-3915
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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 69138 ID Primary

Addresses

Primary practice location

115 W Main St Ste 101
Boise, ID 83702-7304

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

2500 W A St Ste 101
Moscow, ID 83843-6000
Phone (208) 882-0540

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
I20210916002014 ID Practitioner - Nurse Practitioner 7416354576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

115 W Main St
Suite 101
Boise, ID 83702-7304
Phone (208) 381-3915

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gritman Medical Center Inc CurrentSince Sep 1, 2021 Accepting new patients
Gritman Medical Center Inc. CurrentSince Sep 1, 2021 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jul 17, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jul 17, 2023 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

115 W Main St
Ste 101
Boise, ID 83702
Phone (208) 343-3652

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

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

700 S Main St
Moscow, ID 83843
Phone (208) 746-7555

623 S Main St
Ste 1
Moscow, ID 83843
Phone (208) 882-2011

9850 W St Lukes Dr
Ste 260
Nampa, ID 83687
Phone (208) 381-3915

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1487322012",
    "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": "115 W MAIN ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027304",
            "telephone_number": "208-381-3915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W A St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838436000",
            "country_code": "US",
            "telephone_number": "208-882-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "CAMILLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "69138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.