Active NPI
Sengpraseuth Johnny Luangaphay, RN
- General Practice Registered Nurse
- Boise, ID
National Provider Identifier
1508514449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 41733
- Practice address
- 500 W Fort St
Boise, ID 83702-4501 - Phone
- (208) 422-1000
- NPI assigned
- Mar 10, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 41733 | ID | Primary |
Addresses
Primary practice location
500 W Fort St
Boise, ID 83702-4501
Mailing address
500 W Fort St
Boise, ID 83702-4501
Phone (208) 422-1000
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41733 | ID | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646870400000",
"number": "1508514449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W FORT ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024501",
"telephone_number": "208-422-1000",
"fax_number": "208-422-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W FORT ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024501",
"telephone_number": "208-422-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUANGAPHAY",
"first_name": "SENGPRASEUTH",
"middle_name": "JOHNNY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-10",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "ID",
"license": "41733",
"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 Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.