Northwest Telepsychiatry, PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NORTHWEST TELEPSYCHIATRY, PC

Practice address

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

Phone

(208) 323-1125

NPI assigned

Apr 17, 2019

Last updated

May 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Bates, MDNPI 1720170228

Title

Owner

Phone

(208) 323-1125

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 3

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.

• John Robert Bates, M.D.

  • Psychiatry Physician
  • Lander, WY
  • NPI 1720170228
  Medicare reassignment Care Compare group Authorized official
• Caitlin Haley Murphy

  • Psychiatric/Mental Health Nurse Practitioner
  • Lander, WY
  • NPI 1598625659
  Medicare reassignment Care Compare group NPD
• Carolyn Marie Renner, MS, RDN, LD

  • Registered Dietitian
  • Lander, WY
  • NPI 1962707687
  NPD

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1568025336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST TELEPSYCHIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-323-1125",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Osteoscreening (NW Health & OsteoScreening)
• Northwest Paramedic Associates Inc.
• Northwest Physical Medicine and Rehabilitation PLLC
• Northwest Professionals Family Resource Center
• Northwest Radiation Oncology PA
• Caroline Nicole Norton
• Gerene Hamilton Norton, M.S. CCC SLP CCCA
• Kyle Noskoviak, M.D.
• Janelle Nicole Nostrandt, LCSW
• Charles Chris Novak, MD

• 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 May 2, 2019; 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.