Active NPI
Scott Wilson
- Other Technician
- Boise, ID
National Provider Identifier
1639030968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 7512 W Lemhi St Ste 2
Boise, ID 83709-2877 - Phone
- (801) 430-8550
- NPI assigned
- Nov 18, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | ID | Primary |
Addresses
Primary practice location
7512 W Lemhi St Ste 2
Boise, ID 83709-2877
Mailing address
430 N Station Pkwy Apt 554
Farmington, UT 84025-3151
Phone (801) 430-8550
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1639030968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 N STATION PKWY APT 554",
"city": "FARMINGTON",
"state": "UT",
"postal_code": "840253151",
"telephone_number": "801-430-8550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7512 W LEMHI ST STE 2",
"city": "BOISE",
"state": "ID",
"postal_code": "837092877",
"telephone_number": "801-430-8550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SCOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-18",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.