Essential Life Boise, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

CHIA1466 Issued in ID

Legal business name

ESSENTIAL LIFE BOISE, LLC

Practice address

13125 W Persimmon LN
Suite 100
Boise, ID 83713

Phone

(208) 991-0352

NPI assigned

Jul 18, 2012

Last updated

Jul 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yvonne Fedewa

Title

Owner

Phone

(208) 991-0352

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yvonne Rose Fedewa Aicher, D.C.

  • Chiropractor
  • Boise, ID
  • NPI 1689955809
  NPD (past)
• Victor M Sanchez, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1801820451
  NPD (past)

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1669727400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 W PERSIMMON LN",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13125 W PERSIMMON LN",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-991-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL LIFE BOISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "FEDEWA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-991-0352"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "ID",
            "license": "CHIA1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talia Joann Esplin, LPC
• Meghan Ann Feeney Esposito, LPC, PMH-C
• Nicholas Esposito
• Olga Esquivel Lira, LCSW
• Essential Life Boise
• Rachel Essig, LMSW
• Michael E. Estess, M. D.
• Luchette Esteves, APRN
• John M Etchart, MD
• Linsey Etherington, MD

• Medical Specialty Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Medical Specialty Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.