Active NPI
Michael Ray Cerchione
- Social Worker
- Emmett, ID
National Provider Identifier
1629358288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- L-2382
- Practice address
- 2007 E Quail Run Rd # 2
Emmett, ID 83617-5059 - Phone
- (208) 365-2525
- Fax
- (208) 365-2234
- NPI assigned
- Aug 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | L-2382 | ID | Primary |
Addresses
Primary practice location
2007 E Quail Run Rd # 2
Emmett, ID 83617-5059
Mailing address
2007 E. Quail Run Road
#2
Emmett, ID 83617
Phone (208) 949-4479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-2382 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1629358288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2007 E. QUAIL RUN ROAD",
"address_2": "#2",
"city": "EMMETT",
"state": "ID",
"postal_code": "83617",
"telephone_number": "208-949-4479",
"fax_number": "208-365-2234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2007 E QUAIL RUN RD # 2",
"city": "EMMETT",
"state": "ID",
"postal_code": "836175059",
"telephone_number": "208-365-2525",
"fax_number": "208-365-2234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERCHIONE",
"first_name": "MICHAEL",
"middle_name": "RAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "L-2382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emmett, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.