Individual provider Active NPI

Sunny Raichart, FNP

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1720687106
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66088 Issued in ID
Practice address
2001 S Woodruff Ave Ste 15B
Idaho Falls, ID 83404-6372
Phone
(208) 357-4633
NPI assigned
Oct 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66088 ID Primary

Addresses

Primary practice location

2001 S Woodruff Ave Ste 15B
Idaho Falls, ID 83404-6372

Mailing address

4224 E 410 N
Rigby, ID 83442-5518
Phone (208) 589-4609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201202000289 ID Practitioner - Nurse Practitioner 4587074232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine Hub PLLCGroup PAC ID 9537422662, 6 clinicians

Practice addresses (Care Compare)

2001 S Woodruff Ave
Idaho Falls, ID 83404-6372
Phone (208) 357-4633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Hub PLLC CurrentSince Oct 28, 2020 Accepting new patients
Flower Aston Nutrition LLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

2001 S Woodruff Ave
Ste 15B
Idaho Falls, ID 83404
Phone (208) 357-4633

Interoperability endpoints

  • Direct secure messaging: sunny.raichart.1@19202.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1720687106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 E 410 N",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425518",
            "telephone_number": "208-589-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 15B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046372",
            "telephone_number": "208-357-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAICHART",
        "first_name": "SUNNY",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.