Individual provider Active NPI

Andrea Jones, PA-C

  • Physician Assistant
  • Caldwell, ID
National Provider Identifier
1871222182
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2402 Issued in ID
Practice address
808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone
(208) 459-1025
Fax
(208) 466-5359
NPI assigned
Jun 10, 2022
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PA-2402 ID Primary

Addresses

Primary practice location

808 Cleveland Blvd
Caldwell, ID 83605-4168

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 461-7149

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230119002856 ID Practitioner - Physician Assistant 5890166383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

150 2ND St
Melba, ID 83641-5199
Phone (208) 495-1011

207 1St St S
Nampa, ID 83651-3703
Phone (208) 466-7869

808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone (208) 459-1025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. CurrentSince Dec 12, 2022 Accepting new patients
Community Health Clinics, Inc. Physician Assistant Past Accepting new patients
Community Health Clinics, Inc. Physician Assistant Past Accepting new patients

Locations

300 S 23rd St
Boise, ID 83702
Phone (208) 344-3512

400 N Allumbaugh St
Boise, ID 83704
Phone (208) 377-9180

848 S La Cassia Dr
Boise, ID 83705
Phone (208) 344-0086

108 E Idaho Ave
Homedale, ID 83628
Phone (208) 337-3189

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

201 S Paradise Ave
Middleton, ID 83644
Phone (208) 585-0048

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

Interoperability endpoints

  • Direct secure messaging: ajones611514@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1871222182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-461-7149",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054168",
            "telephone_number": "208-459-1025",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.