NPIMap

Organization Active NPI

Michael E. Estess, M. D. Chartered

  • Preferred Provider Organization
  • Boise, ID
National Provider Identifier
1558585455
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
M-3173 Issued in ID
Legal business name
MICHAEL E. ESTESS, M. D. CHARTERED
Practice address
1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879
Phone
(208) 345-2630
Fax
(208) 345-6504
NPI assigned
Apr 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael E. Estess, M. D.NPI 1003030099
Title
President
Phone
(208) 345-2630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X M-3173 ID Primary

Addresses

Primary practice location

1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879

Mailing address

1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879
Phone (208) 345-2630

Other identifiers 2

IdentifierTypeStateIssuer
000010003612OtherIDBLUE SHIELD
DG399OtherIDBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558585455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 SHORELINE DR",
            "address_2": "SUITE 119",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026879",
            "telephone_number": "208-345-2630",
            "fax_number": "208-345-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 SHORELINE DR",
            "address_2": "SUITE 119",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026879",
            "telephone_number": "208-345-2630",
            "fax_number": "208-345-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. ESTESS, M. D. CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESTESS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-345-2630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "ID",
            "license": "M-3173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010003612",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "DG399",
            "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 Aug 22, 2020; 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.