Individual provider Active NPI

Gregory Scott Meyer, LCSW, CBIS

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1497023212
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW25022 Issued in ID
Practice address
600 N Robbins Rd
Idao Elks Rehab Hospital
Boise, ID 83702-4565
Phone
(208) 480-4963
Fax
(208) 489-4053
NPI assigned
Dec 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW25022 ID Primary

Addresses

Primary practice location

600 N Robbins Rd
Idao Elks Rehab Hospital
Boise, ID 83702-4565

Mailing address

600 N Robbins Rd
Idao Elks Rehab Hospital
Boise, ID 83702
Phone (208) 480-4963

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

State licenses

LicenseStateTypeSpecialty
LCSW25022IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1497023212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N ROBBINS RD",
            "address_2": "IDAO ELKS REHAB HOSPITAL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-480-4963",
            "fax_number": "208-489-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ROBBINS RD",
            "address_2": "IDAO ELKS REHAB HOSPITAL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024565",
            "telephone_number": "208-480-4963",
            "fax_number": "208-489-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LCSW, CBIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW25022",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 7, 2011; 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.