NPIMap

Individual provider Active NPI

Amanda Kaye Hall, D.O.

  • Nephrology Physician
  • Meridian, ID
National Provider Identifier
1871737973
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
O-0858 Issued in ID
Practice address
3525 E Louise Dr Ste 195
Meridian, ID 83642
Phone
(208) 846-8335
Fax
(208) 846-8336
NPI assigned
Apr 21, 2009
Last updated
May 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7771762-1204 UT
Nephrology Physician 207RN0300X O-0858 ID Primary

Addresses

Primary practice location

3525 E Louise Dr Ste 195
Meridian, ID 83642

Mailing address

3525 E Louise Dr Ste 195
Meridian, ID 83642-6303
Phone (208) 846-8335

Other practice location 1

4424 E Flamingo Ave Ste 195
Nampa, ID 83687-9289
Phone (208) 846-8335

Other practice location 2

1109 W Myrtle St Ste 100
Boise, ID 83702-6971
Phone (208) 846-8335

Other practice location 3

4620 Enterprise Way Ste 101
Caldwell, ID 83605-6764
Phone (208) 846-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804003764 ID Practitioner - Nephrology 5890019996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

222 N 2ND St
Suite 315
Boise, ID 83702-6185
Phone (208) 381-6196

3525 E Louise Dr
Meridian, ID 83642-6303

520 S Eagle Rd
Meridian, ID 83642-6351

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711

9850 St Lukes Dr
Nampa, ID 83687-7912

9850 W St Luke's Dr
Nampa, ID 83687-7912

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7771762-1204UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

222 N 2nd St
Ste 315
Boise, ID 83702
Phone (208) 336-4825

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

4620 Enterprise Way
#101
Caldwell, ID 83605
Phone (208) 454-1101

3525 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 999-0356

3525 E Louise Dr
Ste 195
Meridian, ID 83642

Interoperability endpoints

  • Direct secure messaging: ahall24832@direct.slhs.org

Organizations & group practices 2

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 12

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1871737973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR STE 195",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426303",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR STE 195",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4424 E Flamingo Ave Ste 195",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836879289",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1109 W Myrtle St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026971",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4620 Enterprise Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836056764",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "AMANDA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "7771762-1204",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "O-0858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.