Elizabeth A Davis, MD
Individual provider Active NPI Emergency Medicine Physician · Boise, ID
NPI 1801074232 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1801074232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- M-13502 (ID)
- Practice address
- 6051 W Emerald St
Boise, ID 83704-8969 - Phone
- (208) 302-5150
- Fax
- (208) 230-2051
- NPI assigned
- Feb 7, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Utah School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Alphonsus Regional Medical Center Inc
Saint Alphonsus Medical Center- Ontario Inc
Practice addresses (Care Compare)
10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone (208) 302-5900
10717 W State St
Star, ID 83669-6046
Phone (208) 302-6300
11035 Karcher Rd
Nampa, ID 83651-8200
Phone (208) 302-2100
1150 N Sister Catherine Way
Nampa, ID 83687-3133
Phone (208) 302-7000
3025 W Cherry LN
Meridian, ID 83642-8531
6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603
6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000
712 Aviation Way
Caldwell, ID 83605-1154
Phone (208) 302-1035
757 E Wythe Creek CT
Suite 100
Kuna, ID 83634-5006
Phone (208) 302-6500
867 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 302-7950
910 NW 16TH St
Fruitland, ID 83619-2265
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170120000858 | ID | Practitioner - Family Practice |
2769568989 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1432 | KY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients | |
| Southern Idaho Health Partners LLC | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current |
Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current |
Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current |
Accepting new patients | |
| Churchill Mangat Emergency Group PC | Emergency Medicine | Past | Accepting new patients |
Locations
6051 W Emerald St
Boise, ID 83704
Phone (208) 302-5100
910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000
3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
9850 W St Lukes Dr
Ste 129
Nampa, ID 83687
Phone (208) 205-7600
217 W Georgia Ave
Ste 115
Nampa, ID 83686
Phone (208) 463-3234
215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234
Interoperability endpoints
- edavis3358486@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | R1432 | KY | |
| Family Medicine Physician | 207Q00000X | M-13502 | ID | |
| Emergency Medicine Physician | 207P00000X | M-13502 | ID | Yes |
Addresses
Primary practice location
6051 W Emerald St
Boise, ID 83704-8969
Mailing address
PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170
Other practice location 1
215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3000
Other providers in Boise, ID
- Brittney Davis
- Charlene Davis
- Charles Michael Davis
- Cole Davis
- Derek C. Davis
- Emily Jo Davis
- Emma Davis
- Genevieve Davis
- Hallie Davis
- Jaimee K Davis
All providers in Boise, ID · Emergency Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.