NPIMap

Individual provider Active NPI

Abby Davids, MD

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1780970491
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-12366 Issued in ID
Practice address
6565 W Emerald St
Boise, ID 83704-8737
Phone
(208) 514-2510
Fax
(208) 375-2217
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 248510 MA
Family Medicine Physician 207Q00000X M-12366 ID Primary

Addresses

Primary practice location

6565 W Emerald St
Boise, ID 83704-8737

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1780970491MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804001368 ID Practitioner - Family Practice 4486892122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2011
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)

325 W Idaho St
Boise, ID 83702-6040
Phone (208) 514-2525

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-12366IDMDFamily Medicine Physician
248510MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince Aug 1, 2014 Accepting new patients
St Lukes Regional Medical Center PastSince Aug 1, 2014 Accepting new patients

Locations

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

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

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

215 W 35th St
Garden City, ID 83714
Phone (208) 384-5200

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

Interoperability endpoints

  • Direct secure messaging: adavids295102@direct.ochin.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Full Circle HealthNampa, ID, CCN 131879 Federally qualified health center Corporate Director Jul 1, 2023
Full Circle HealthNampa, ID, CCN 131885 Federally qualified health center Corporate Director Jul 1, 2023
Full Circle Health IncCaldwell, ID, CCN 131055 Federally qualified health center W-2 Managing Employee Jul 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 5

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1780970491",
    "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": "6565 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048737",
            "telephone_number": "208-514-2510",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDS",
        "first_name": "ABBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "248510",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-12366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780970491",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.