Individual provider Active NPI

Trevor Spence, NP-C

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1669063384
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53451 Issued in ID
Practice address
3301 N Sawgrass Way
Boise, ID 83704-4493
Phone
(208) 375-2658
NPI assigned
Jan 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95016395 CA
Nurse Practitioner 363L00000X 53451 ID Primary

Addresses

Primary practice location

3301 N Sawgrass Way
Boise, ID 83704-4493

Mailing address

5373 W Milano Dr
Meridian, ID 83646-7603

Other practice location 1

206 E Elm St
Caldwell, ID 83605-4815
Phone (208) 459-4511

Other practice location 2

5373 W Milano Dr
Meridian, ID 83646-7603
Phone (208) 241-8887

Other practice location 3

1210 NW 16th St
Fruitland, ID 83619-2202
Phone (208) 459-4511

Other practice location 4

3875 E Overland Rd Ste 106
Meridian, ID 83642-9005
Phone (208) 895-0888

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
I20230419001394 ID Practitioner - Nurse Practitioner 7618342981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians
Direct Orthopedic Care LLCGroup PAC ID 2163648155, 32 clinicians

Practice addresses (Care Compare)

3301 N Sawgrass Way
Boise, ID 83704-4493
Phone (208) 375-0862

7979 W Rifleman St
Suite 110
Boise, ID 83704-9066
Phone (208) 321-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016395CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Orthopedic Care LLC Orthopaedic Surgery CurrentSince Jan 1, 2025 Accepting new patients
Direct Orthopedic Care LLC Orthopaedic Surgery CurrentSince Jan 1, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Sep 3, 2024 Accepting new patients
Richard Lochhead MD PLLC PastSince Jul 1, 2015 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

7979 W Rifleman St
Ste 110
Boise, ID 83704
Phone (208) 321-4000

7979 W Rifleman St
Boise, ID 83704
Phone (208) 321-4000

3301 N Sawgrass Way
Boise, ID 83704
Phone (208) 375-0862

1789 S Broadway Ave
Ste 100
Boise, ID 83706
Phone (208) 287-0203

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567

Organizations & group practices 5

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 2

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": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1669063384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5373 W MILANO DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N SAWGRASS WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044493",
            "telephone_number": "208-375-2658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 E Elm St",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054815",
            "country_code": "US",
            "telephone_number": "208-459-4511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5373 W Milano Dr",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836467603",
            "country_code": "US",
            "telephone_number": "208-241-8887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 NW 16th St",
            "address_purpose": "LOCATION",
            "city": "Fruitland",
            "state": "ID",
            "postal_code": "836192202",
            "country_code": "US",
            "telephone_number": "208-459-4511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3875 E Overland Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836429005",
            "country_code": "US",
            "telephone_number": "208-895-0888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "TREVOR",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016395",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "53451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.