Individual provider Active NPI

Tamara M McDonald, DNP, PMHNP, FNP

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1649840646
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57548 Issued in ID
Practice address
3527 S Federal Way Ste 103-414
Boise, ID 83705-5204
Phone
(208) 918-4080
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 57548 ID Primary

Addresses

Primary practice location

3527 S Federal Way Ste 103-414
Boise, ID 83705-5204

Mailing address

3527 S Federal Way Ste 103-414
Boise, ID 83705-5204

Other practice location 1

500 W Fort St
Boise, ID 83702-4501
Phone (208) 422-1000

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
I20240829004462 ID Order and Referring Only - Nurse Practitioner 8022557370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57548IDMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1649840646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 S FEDERAL WAY STE 103-414",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 S FEDERAL WAY STE 103-414",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055204",
            "telephone_number": "208-918-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Fort St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837024501",
            "country_code": "US",
            "telephone_number": "208-422-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TAMARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "57548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.