Active NPI
Nicole L Thurston, MD
- Psychiatry Physician
- Boise, ID
National Provider Identifier
1679782460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M10117
- Practice address
- 100 E Idaho St
Boise, ID 83712-6267 - Phone
- (208) 381-2711
- Fax
- (208) 323-9604
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M10117 | ID | Primary |
Addresses
Primary practice location
100 E Idaho St
Boise, ID 83712-6267
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807932200 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
190 E Bannock St
Boise, ID 83712-6241
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M10117 | ID | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
100 E Idaho St
Ste 200
Boise, ID 83712
Phone (208) 381-7312
100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
Interoperability endpoints
- nthurston39484@direct.slhs.org
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1679782460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222",
"fax_number": "208-323-9604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E IDAHO ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126267",
"telephone_number": "208-381-2711",
"fax_number": "208-323-9604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THURSTON",
"first_name": "NICOLE",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M10117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807932200",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
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- Thrive Community Services, LLC
- Thrive With CBT - a Therapy Place
- Lori Throckmorton, LCSW
- Sara Thurston, AUD
- Jeremiah Lee Tibbitts, DC
- Brook Rose Tiddens, CNM
- Tides Treatment Services
- Tidwell Social Work Services and Consulting, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.