Individual provider Active NPI

Jeffrey D Robbins, FNP

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1669408514
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-750A Issued in ID
Practice address
4776 N Five Mile Rd Ste 101
Boise, ID 83713-2715
Phone
(208) 986-7770
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 NP-750A ID Primary

Addresses

Primary practice location

4776 N Five Mile Rd Ste 101
Boise, ID 83713-2715

Mailing address

4776 N Five Mile Rd Ste 101
Boise, ID 83713-2715
Phone (986) 777-0278

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
I20061108000153 ID Practitioner - Nurse Practitioner 9739186636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4776 N Five Mile Rd
Suite 101
Boise, ID 83713-2715
Phone (986) 777-0278

Hospital & facility affiliations

  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revolutionary Medicine of Idaho Family CurrentSince Jun 25, 2024 Accepting new patients

Locations

4776 N Five Mile Rd
#101
Boise, ID 83713
Phone (208) 658-9500

4776 N Five Mile Rd
#103
Boise, ID 83713
Phone (208) 342-7555

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEEEDD/Endpoint/FEEEDD

Organizations & group practices 1

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 3

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1669408514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4776 N FIVE MILE RD STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "986-777-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4776 N FIVE MILE RD STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-986-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBINS",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-750A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.