Organization Active NPI

Hurst Medical PLLC

  • Clinic/Center
  • Burley, ID
National Provider Identifier
1609335090
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HURST MEDICAL PLLC
Practice address
1700 Overland Ave Ste 1
Burley, ID 83318
Phone
(208) 825-6193
Fax
(208) 825-6199
NPI assigned
Mar 15, 2019
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Cindy Hurst, NPNPI 1265887319
Title
NP, Owner
Phone
(208) 825-6193

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
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1700 Overland Ave Ste 1
Burley, ID 83318

Mailing address

1700 Overland Ave Ste 1
Burley, ID 83318
Phone (208) 825-6193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190524001223 ID Part B Supplier - Clinic/Group Practice 5395088876 Receives reassigned benefits from 1 practitioner
Practice locations: Burley, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2162949Hurst Medical1700 Overland Ave, Burley, ID 83318Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory

Locations

1700 Overland Ave
Ste 1
Burley, ID 83318
Phone (208) 825-6193

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": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1609335090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OVERLAND AVE STE 1",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-825-6193",
            "fax_number": "208-825-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OVERLAND AVE STE 1",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-825-6193",
            "fax_number": "208-825-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURST MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "NP, OWNER",
        "authorized_official_telephone_number": "208-825-6193",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.