Individual provider Active NPI

Shauna Rankin

  • Family Nurse Practitioner
  • Wilder, ID
National Provider Identifier
1740928837
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
72982 Issued in ID
Practice address
27591 Petolla Rd
Wilder, ID 83676-5740
Phone
(208) 375-8427
NPI assigned
May 26, 2022
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 72982 ID Primary

Addresses

Primary practice location

27591 Petolla Rd
Wilder, ID 83676-5740

Mailing address

27591 Petolla Rd
Wilder, ID 83676-5740
Phone (208) 375-8427

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
I20220712002918 ID Practitioner - Nurse Practitioner 6406236199 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

512 N 21St Ave
Caldwell, ID 83605-4368
Phone (208) 809-2875

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
77.29
Promoting interoperability
97
Improvement activities
40
Cost
74.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72982IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All Horizons, Inc. CurrentSince Apr 15, 2024 Accepting new patients
All Horizons Inc Current Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince Jul 20, 2022 Accepting new patients
Alliance Medical Group, LLC Family Medicine Current Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Sep 7, 2023 Accepting new patients
Alliance Medical Group, LLC Family Medicine Past Accepting new patients
All Seasons Mental Health Past Accepting new patients

Locations

300 W Myrtle St
Ste 100
Boise, ID 83702
Phone (208) 472-9082

6933 W Emerald St
Boise, ID 83704
Phone (208) 321-0634

6933 W Emerald St
Ste A
Boise, ID 83704

7350 W Victory Rd
Boise, ID 83709
Phone (208) 809-2888

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

4815 Cleveland Blvd
Caldwell, ID 83605
Phone (208) 455-3545

512 N 21st Ave
Caldwell, ID 83605
Phone (208) 809-2875

1895 McGrath Rd
Eagle, ID 83616
Phone (208) 939-8200

435 S Eagle Rd
Ste 100
Eagle, ID 83616
Phone (208) 609-9130

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

5601 W Chinden Blvd
Garden City, ID 83714
Phone (208) 809-2865

1623 S Wells Ave
Meridian, ID 83642
Phone (208) 489-1450

260 S Ten Mile Rd
Meridian, ID 83642
Phone (208) 809-2872

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: shauna.rankin@phmg.eclinicaldirectplus.com

Organizations & group practices 7

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 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1740928837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27591 PETOLLA RD",
            "city": "WILDER",
            "state": "ID",
            "postal_code": "836765740",
            "telephone_number": "208-375-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27591 PETOLLA RD",
            "city": "WILDER",
            "state": "ID",
            "postal_code": "836765740",
            "telephone_number": "208-375-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "SHAUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "72982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilder, ID

Sources for this page

Verify at the official NPI Registry.