NPIMap

Individual provider Active NPI

Mark B Cheney, DO

  • Family Medicine Physician
  • Meridian, ID
National Provider Identifier
1659504314
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O0680 Issued in ID
Practice address
3025 W Cherry Lane
Meridian, ID 83642
Phone
(208) 302-6400
Fax
(208) 302-6455
NPI assigned
Aug 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 58003156 OH
Family Medicine Physician 207Q00000X O0680 ID Primary

Addresses

Primary practice location

3025 W Cherry Lane
Meridian, ID 83642

Mailing address

3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 302-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120906000548 ID Practitioner - Family Practice 0648427138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O0680IDMDFamily Medicine Physician
58003156OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jun 1, 2018 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jun 1, 2018 Accepting new patients

Locations

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Ste A
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste 205
Meridian, ID 83642
Phone (208) 367-8484

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: mcheney1564006@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1659504314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-6400",
            "fax_number": "208-302-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 W CHERRY LANE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-6400",
            "fax_number": "208-302-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEY",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "58003156",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O0680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.