Active NPI
Patricia J Funkhouser, DNP
- Nurse Practitioner
- Nampa, ID
National Provider Identifier
1689295180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 63919
- Practice address
- 215 E Hawaii Ave
Nampa, ID 83686-6011 - Phone
- (208) 463-3000
- NPI assigned
- May 6, 2020
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 63919 | ID | Primary |
Addresses
Primary practice location
215 E Hawaii Ave
Nampa, ID 83686-6011
Mailing address
215 E Hawaii Ave
Nampa, ID 83686-6011
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63919 | ID | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Pediatrics, LLC | Past | Accepting new patients |
Interoperability endpoints
- patricia.funkhouser.1@19555.direct.athenahealth.com
- https://api.platform.athenahealth.com/19555/brand/1/csg/1/fhir/r4
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.
-
- Pediatrics Physician
- Meridian, ID
- NPI 1669934220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1689295180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 E HAWAII AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E HAWAII AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866011",
"telephone_number": "208-463-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNKHOUSER",
"first_name": "PATRICIA",
"middle_name": "J",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-06",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "63919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.