Merjurie Fair Ricklefs, ARNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

66558 Issued in ID

Practice address

3670 S 25TH E Ste 4
Idaho Falls, ID 83404-4956

Phone

(208) 821-0357

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

Yes

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Autumn Leaves Psychiatry, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1396326096

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Advocacy Center

  • Adult Mental Health Clinic/Center
  • Idaho Falls, ID
  • NPI 1760940639
  NPD

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1821693094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 S 25TH E STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044956",
            "telephone_number": "208-821-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S 25TH E STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044956",
            "telephone_number": "208-821-0357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2429 Jafer Ct",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834045587",
            "country_code": "US",
            "telephone_number": "208-712-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKLEFS",
        "first_name": "MERJURIE",
        "middle_name": "FAIR",
        "credential": "ARNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "66558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Scott Richins, D.O.
• Shane Richins, CPRC
• Jennifer Richman, OTR/L
• Daniel B Rick, PA
• Jared William Rickabaugh, APRN, FNP-C
• Deron J Ricks, PA
• Jessica Lynn Ricks, LSW
• Tina Maria Ricks, LMSW
• Ridgeline Medical LLC
• Bethany Richardson Riding, B.S.

• Psychiatric/Mental Health Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.