Amanda Bolin, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

72434 Issued in ID

Practice address

1118 NW 16TH St Ste D
Fruitland, ID 83619-2272

Phone

(208) 452-7677

NPI assigned

Apr 21, 2022

Last updated

Apr 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006
• St. Alphonsus Medical Center - Baker City Hospital, Baker City, OR, CCN 381315
• St Luke's Nampa Medical Center Hospital, Nampa, ID, CCN 130071
• St Luke's McCall Hospital, McCall, ID, CCN 131312
• Weiser Memorial Hospital Hospital, Weiser, ID, CCN 131307

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - Trinity Mountain

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes McCall LTD

  • Critical Access Hospital
  • McCall, ID
  • NPI 1235447970
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  dba St Lukes Nampa Medical Center

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation
• Weiser Valley Hospital District

  dba Weiser Memorial Hospital

  • Critical Access Hospital
  • Weiser, ID
  • NPI 1881641629
  Care Compare affiliation
• Weiser Valley Hospital District

  • Specialist
  • Weiser, ID
  • NPI 1932650561

  Hospital

  Care Compare affiliation
• Saint Alphonsus Medical Center Baker City, Inc

  • Critical Access Hospital
  • Baker City, OR
  • NPI 1386636355
  Care Compare affiliation

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1780328393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 HOOD RD",
            "city": "VALE",
            "state": "OR",
            "postal_code": "979185370",
            "telephone_number": "541-212-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 NW 16TH ST STE D",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192272",
            "telephone_number": "208-452-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "AMANDA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "72434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sage Michele Benintendi-Stringer, PA
• Christina Heninger Benson, PA
• Matthew Joseph Berria, PA
• Cami Lynn Blackburn, LMSW
• Bluebird Support Services LLC
• Anne K Boster, DONA
• Lyle Spencer Bourcy, LCPC
• Bourner Counseling Services
• Jared Anthony Bradford, PA
• Charles Edward Brioschi Jr., PA

• Family Nurse Practitioner in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.