Individual provider Active NPI

Nykol Bailey, CRNA

  • Psychiatric/Mental Health Nurse Practitioner
  • Boise, ID
National Provider Identifier
1760872865
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
70140 Issued in ID
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(435) 459-4194
NPI assigned
Jan 27, 2015
Last updated
Sep 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 70140 ID Primary
Certified Registered Nurse Anesthetist 367500000X 105690 ID

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

210 N Shirttail Way
Blanding, UT 84511-3220
Phone (435) 459-4194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515001413 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183944077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Cincinnati College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Boise, P.a.Group PAC ID 2668385287, 183 clinicians

Practice addresses (Care Compare)

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science

State licenses

LicenseStateTypeSpecialty
70140IDMDPsychiatric/Mental Health Nurse Practitioner
105690IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Boise, P.a. Multi-Specialty CurrentSince Apr 9, 2015 Accepting new patients
Boise Ketamine Clinic CurrentSince Apr 11, 2021 Accepting new patients
Healing House PLLC Multi-Specialty CurrentSince Jun 1, 2022 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

1000 State St
McCall, ID 83638
Phone (208) 634-2221

Interoperability endpoints

  • Direct secure messaging: nykol.bailey@471.emedpractice.direct-ci.com

Organizations & group practices 3

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1760872865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N SHIRTTAIL WAY",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113220",
            "telephone_number": "435-459-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "435-459-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "NYKOL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "70140",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "105690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.