Marc Bostick MD Chartered

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

M7712 Issued in ID

Legal business name

MARC BOSTICK MD CHARTERED

Practice address

413 N Allumbaugh St
Ste 101
Boise, ID 83704-9219

Phone

(208) 323-1125

Fax

(208) 323-9604

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Cheri Peterson

Title

Credentialer

Phone

(208) 954-5594

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marc Wayne Bostick, MD

  • Psychiatry Physician
  • Boise, ID
  • NPI 1073545703

  ID

  Medicare reassignment

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1508034802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC BOSTICK MD CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "208-954-5594"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M7712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valer Mapendo, LMSW
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• Maple Grove Surgical LLC
• Kelci Denae Mar, DPT
• Roberta Mendiola Maratita
• Lesley March
• Elena Marchesan, LPC
• Joseph Nicholas Marchesani, M.D.
• Gabrielle Hope Gequillana Marchese, PHARMD
• Cody James Marchetti, DO

• Psychiatry Physician in Boise, ID
• Providers in Boise, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.