Essential Life Boise

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

CHIA1466 Issued in ID

Legal business name

ESSENTIAL LIFE BOISE

Practice address

13125 W Persimmon LN
Ste 100
Boise, ID 83713-2086

Phone

(208) 991-0352

NPI assigned

May 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Yvonne Fedewa

Title

Owner

Phone

(208) 991-0352

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frances Emily Alves De Melo, D.C.

  • Chiropractor
  • Boise, ID
  • NPI 1245271477
  NPD (past)
• Victor M Sanchez, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1801820451
  NPD (past)
• Benjamin Edward Jeppe, D.C., AGPCNP

  • Nurse Practitioner
  • Roseburg, OR
  • NPI 1598702367
  NPD (past)

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1841550126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 W PERSIMMON LN",
            "address_2": "STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13125 W PERSIMMON LN",
            "address_2": "STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132086",
            "telephone_number": "208-991-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL LIFE BOISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "FEDEWA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-991-0352",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "ID",
            "license": "CHIA1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stan V Esplin
• Talia Joann Esplin, LPC
• Meghan Ann Feeney Esposito, LPC, PMH-C
• Nicholas Esposito
• Olga Esquivel Lira, LCSW
• Essential Life Boise, LLC
• Rachel Essig, LMSW
• Michael E. Estess, M. D.
• Luchette Esteves, APRN
• John M Etchart, MD

• Medical Specialty Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Medical Specialty Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.