Individual provider Active NPI

Gretchen Ruth Gayle, P.M.H.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1649757279
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
59790 Issued in ID
Practice address
2321 E Gala St Ste 3
Meridian, ID 83642-7692
Phone
(208) 888-5848
NPI assigned
Jul 26, 2018
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 59790 ID Primary

Addresses

Primary practice location

2321 E Gala St Ste 3
Meridian, ID 83642-7692

Mailing address

1550 N Crestmont Dr
Meridian, ID 83642-2184
Phone (208) 288-4200

Other practice location 1

1550 N Crestmont Dr
Meridian, ID 83642-2184
Phone (208) 288-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190225002029 ID Practitioner - Nurse Practitioner 5294074936 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midvalley Healthcare PLLCGroup PAC ID 0749327880, 17 clinicians

Practice addresses (Care Compare)

2321 E Gala St
Suite 3
Meridian, ID 83642-7692
Phone (208) 888-5848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midvalley Healthcare PLLC CurrentSince Nov 6, 2018 Accepting new patients
Dwyer & Harrington, PLLC CurrentSince Feb 1, 2019 Accepting new patients

Locations

303 N Allumbaugh St
Ste 335
Boise, ID 83704
Phone (208) 888-5848

5985 W State St
Boise, ID 83703
Phone (208) 853-0071

2321 E Gala St
Ste 3
Meridian, ID 83642
Phone (208) 288-2280

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1649757279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N CRESTMONT DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422184",
            "telephone_number": "208-288-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 E GALA ST STE 3",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427692",
            "telephone_number": "208-888-5848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 N Crestmont Dr",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836422184",
            "country_code": "US",
            "telephone_number": "208-288-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYLE",
        "first_name": "GRETCHEN",
        "middle_name": "RUTH",
        "credential": "P.M.H.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "59790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.