NPIMap

Organization Active NPI

Family Care Clinic

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1770817413
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CARE CLINIC
Practice address
8050 W Rifleman St Ste 100
Boise, ID 83704-9000
Phone
(208) 321-0634
Fax
(208) 321-1082
NPI assigned
Sep 29, 2009
Last updated
Jan 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Laurie Miller
Title
Office Manager
Phone
(208) 321-0634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

8050 W Rifleman St Ste 100
Boise, ID 83704-9000

Mailing address

8050 W Rifleman St Ste 100
Boise, ID 83704-9000
Phone (208) 321-0634

Other identifiers 1

IdentifierTypeStateIssuer
002803300MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
All Horizons Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1770817413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 W RIFLEMAN ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049000",
            "telephone_number": "208-321-0634",
            "fax_number": "208-321-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 W RIFLEMAN ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049000",
            "telephone_number": "208-321-0634",
            "fax_number": "208-321-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-321-0634"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002803300",
            "state": "ID"
        }
    ],
    "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 Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.