NPIMap

Organization Active NPI

Mercy in Action Vineyard Inc

Doing business as Mercy Birth Center

  • Birthing Clinic/Center
  • Boise, ID
National Provider Identifier
1861862534
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Birthing Clinic/CenterTaxonomy code 261QB0400X
License
MID-3 Issued in ID
Legal business name
MERCY IN ACTION VINEYARD INC
Doing business as
Mercy Birth Center
Practice address
3018 W Overland Rd
Boise, ID 83705-3059
Phone
(208) 608-5954
Fax
(208) 575-8737
NPI assigned
Oct 6, 2015
Last updated
Oct 6, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY IN ACTION VINEYARD INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Rose E Penwell, CPM, LM, BSM
Title
Clinical Director
Phone
(208) 570-4578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Birthing Clinic/Center 261QB0400X MID-3 ID Primary

Addresses

Primary practice location

3018 W Overland Rd
Boise, ID 83705-3059

Mailing address

3018 W Overland Rd
Boise, ID 83705-3059
Phone (208) 608-5954

Other identifiers 1

IdentifierTypeStateIssuer
MID-3OtherIDIDAHO BOARD OF OCCUPATIONAL LICENSING

Other names 1

  • Mercy Birth Center Doing business as

National Provider Directory

National Provider Directory
Part of
Mercy in Action Vineyard Inc

Locations

3018 W Overland Rd
Boise, ID 83705
Phone (208) 608-5954

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1861862534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053059",
            "telephone_number": "208-608-5954",
            "fax_number": "208-575-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053059",
            "telephone_number": "208-608-5954",
            "fax_number": "208-575-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY IN ACTION VINEYARD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY IN ACTION VINEYARD INC",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "PENWELL",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-570-4578",
        "authorized_official_credential": "CPM, LM, BSM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "ID",
            "license": "MID-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO BOARD OF OCCUPATIONAL LICENSING",
            "identifier": "MID-3",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Birth Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.