Active NPI
Jacob Merlin Harris, M.D.
- Addiction Medicine (Psychiatry & Neurology) Physician
- Boise, ID
National Provider Identifier
1679717946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) Physician
- License
- M-12487
- Practice address
- 500 W Fort St
Boise, ID 83702-4599 - Phone
- (208) 422-1000
- Fax
- (208) 422-1270
- NPI assigned
- Apr 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | M-12487 | ID | Primary |
Addresses
Primary practice location
500 W Fort St
Boise, ID 83702-4599
Mailing address
500 W Fort St
Boise, ID 83702-4599
Phone (208) 422-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-12487 | ID | MD | Addiction Medicine (Psychiatry & Neurology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1679717946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W FORT ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024599",
"telephone_number": "208-422-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W FORT ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024599",
"telephone_number": "208-422-1000",
"fax_number": "208-422-1270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "JACOB",
"middle_name": "MERLIN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-29",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "ID",
"license": "M-12487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.