Individual provider Active NPI

Heidi Line, FNP

  • Nurse Practitioner
  • Caldwell, ID
National Provider Identifier
1730809179
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2371354 Issued in ID
Practice address
315 E Elm St # 201
Caldwell, ID 83605-4857
Phone
(208) 514-2528
Fax
(208) 375-2217
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 66314 ID
Nurse Practitioner 363L00000X 2371354 ID Primary

Addresses

Primary practice location

315 E Elm St # 201
Caldwell, ID 83605-4857

Mailing address

777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500

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
I20251104003461 ID Practitioner - Nurse Practitioner 2264922723 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
Group practices
Full Circle Health IncGroup PAC ID 6709986797, 106 clinicians

Practice addresses (Care Compare)

315 E Elm St
Suite 201
Caldwell, ID 83605-4857
Phone (208) 514-2528

Hospital & facility affiliations

  • West Valley Medical Center Hospital, Caldwell, ID, CCN 130014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66314IDMDRegistered Nurse
2371354IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince Oct 13, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

6565 W Emerald St
Boise, ID 83704
Phone (208) 377-5055

325 W Idaho St
Boise, ID 83702
Phone (208) 514-2525

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

315 E Elm St
#201
Caldwell, ID 83605
Phone (208) 514-2528

315 E Elm St
Ste 201
Caldwell, ID 83605
Phone (208) 514-2528

2275 S Eagle Rd
Ste 120
Meridian, ID 83642
Phone (208) 514-2520

Interoperability endpoints

  • Direct secure messaging: hline819716@direct.ochin.org

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 2

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1730809179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E ELM ST # 201",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054857",
            "telephone_number": "208-514-2528",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINE",
        "first_name": "HEIDI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "66314",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "2371354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.