Individual provider Active NPI

Cheryl A Loetscher, NP

  • Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1689766834
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP751A Issued in ID
Practice address
1522 17TH Street
Lewiston, ID 83501
Phone
(208) 743-8416
Fax
(208) 743-4642
NPI assigned
Sep 28, 2006
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP751A ID Primary

Addresses

Primary practice location

1522 17TH Street
Lewiston, ID 83501

Mailing address

PO Box 341
Lewiston, ID 83501-0341
Phone (208) 743-8416

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cheryl.loetscher@tsmh.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070129000695 ID Practitioner - Nurse Practitioner 4789685025 Reassigns benefits to 2 organizations
I20200415001091 WA Practitioner - Nurse Practitioner 4789685025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP751AIDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vannvei LLC CurrentSince Jan 1, 2021 Accepting new patients
Tri-State Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Tri-State Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Vannvei LLC CurrentSince Jan 1, 2021 Accepting new patients
Tri-State Memorial Hospital CurrentSince Apr 1, 2020 Accepting new patients

Locations

1522 17th St
Lewiston, ID 83501
Phone (208) 743-8416

2841 Juniper Dr
#2
Lewiston, ID 83501
Phone (208) 848-9001

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1119 Highland Ave
Clarkston, WA 99403
Phone (509) 758-1450

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1689766834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 341",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835010341",
            "telephone_number": "208-743-8416",
            "fax_number": "208-743-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 17TH STREET",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-743-8416",
            "fax_number": "208-743-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOETSCHER",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP751A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cheryl.loetscher@tsmh.medicity.net",
            "affiliation": "N",
            "address_1": "1522 17th Street",
            "city": "Lewiston",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.