Adrian Avila, RN, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Caldwell, ID
NPI 1619545936 · NPPES record last updated Jul 13, 2022
Key facts
- NPI
- 1619545936
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 53602 (ID)
- Practice address
- 314 Badiola St
Caldwell, ID 83605-4389 - Phone
- (541) 539-1124
- NPI assigned
- Jun 14, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- All Horizons Inc
Practice addresses (Care Compare)
1007 W Orchard Ave
Nampa, ID 83651-1878
Phone 2083210634110
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211027002625 | ID | Practitioner - Nurse Practitioner | 4880097435 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Horizons Inc | Current |
Accepting new patients | |
| All Horizons, Inc. | Current |
Accepting new patients | |
| Physical Therapy 180 LLC | Current |
Accepting new patients | |
| Mental Health Clinic of Idaho PLLC | Current |
Accepting new patients |
Locations
6933 W Emerald St
Boise, ID 83704
Phone (208) 321-0634
3919 E Overland Rd
Meridian, ID 83642
Phone (208) 506-3618
1135 W Airbase Rd
Mountain Home, ID 83647
Phone (208) 587-2226
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 53602 | ID | Yes |
Addresses
Primary practice location
314 Badiola St
Caldwell, ID 83605-4389
Mailing address
314 Badiola St
Caldwell, ID 83605-4389
Phone (541) 539-1124
Other practice location 1
4477 W Emerald St Ste C100
Boise, ID 83706-2058
Phone (208) 321-0160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53602 | Other | ID | IDAHO BOARD OF NURSING |
Other providers in Caldwell, ID
- Dennis Leon Augustus
- Richard A Augustus
- Daniel Timothy Ault
- Autumn Wind Community Healthcare LLC
- Cama L Averett
- Stephen Aydelotte
- David Babbel
- Maria A Babushkina
- Balance Point Chiropractic
- Balance Point Wellness, PC
All providers in Caldwell, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.