NPIMap

Individual provider Active NPI

Michelle Renee Rick

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1689482648
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3171949 Issued in ID
Practice address
3751 N Cloverdale Rd
Boise, ID 83713-3610
Phone
(208) 321-5073
NPI assigned
Dec 23, 2024
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3171949 ID
Family Nurse Practitioner 363LF0000X 3171949 ID Primary

Addresses

Primary practice location

3751 N Cloverdale Rd
Boise, ID 83713-3610

Mailing address

10323 Colorful Dr
Nampa, ID 83687-5163
Phone (208) 936-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250207001099 ID Practitioner - Nurse Practitioner 4587194410 Reassigns benefits to 1 organization
I20260107001407 OR Practitioner - Nurse Practitioner 4587194410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10323 Colorful Dr
Nampa, ID 83687-5163
Phone (208) 936-9665

3049 SE 140TH Ave
Portland, OR 97236-2829
Phone (208) 936-9665

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3171949IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Medical Service, PLLC Family CurrentSince Mar 24, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1689482648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10323 COLORFUL DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875163",
            "telephone_number": "208-936-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 N CLOVERDALE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837133610",
            "telephone_number": "208-321-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICK",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "3171949",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "3171949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.