College of Western Idaho-Medical Express Care Clinic

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

NP885A Issued in ID

Legal business name

COLLEGE OF WESTERN IDAHO-MEDICAL EXPRESS CARE CLINIC

Practice address

2407 Nampa Caldwell Blvd
No. 168
Nampa, ID 83651-1515

Phone

(208) 562-2200

Fax

(208) 562-2207

NPI assigned

Aug 11, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Sherie Burke

Title

Administrator

Phone

(208) 562-2707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1548549249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 NAMPA CALDWELL BLVD",
            "address_2": "NO. 168",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511515",
            "telephone_number": "208-562-2200",
            "fax_number": "208-562-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 NAMPA CALDWELL BLVD",
            "address_2": "NO. 168",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511515",
            "telephone_number": "208-562-2200",
            "fax_number": "208-562-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE OF WESTERN IDAHO-MEDICAL EXPRESS CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "SHERIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-562-2707",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "ID",
            "license": "NP885A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740475680",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Clinical Nurse Specialist in Nampa, ID
• Providers in Nampa, ID by specialty
• Adult Health Clinical Nurse Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.