NPIMap

Individual provider Active NPI

Terry M Little, D.O.

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1487760740
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-53 Issued in ID
Practice address
4750 N Five Mile Rd
Boise, ID 83713-2715
Phone
(208) 375-0500
Fax
(208) 375-4310
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-53 ID Primary

Addresses

Primary practice location

4750 N Five Mile Rd
Boise, ID 83713-2715

Mailing address

4750 N Five Mile Rd
Boise, ID 83713-2715
Phone (208) 375-0500

Other identifiers 5

IdentifierTypeStateIssuer
S5258OtherIDBLUE CROSS
J3698OtherIDBLUE CROSS
000010000238OtherIDBLUE SHIELD
000010152070OtherIDBLUE SHIELD
004313500MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-53IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Orthopaedic Trauma Associates PastSince Jun 23, 2024 Accepting new patients
Physicians Clinic PLLC Family Medicine PastSince Apr 1, 2000 Accepting new patients
Physicians Clinic PLLC Family Medicine PastSince Apr 1, 2000 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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1487760740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-375-0500",
            "fax_number": "208-375-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-375-0500",
            "fax_number": "208-375-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "TERRY",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-53",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "S5258",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J3698",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010000238",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010152070",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004313500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.