Active NPI
Jacqueline King
- Ambulatory Surgical Clinic/Center
- Meridian, ID
National Provider Identifier
1871749408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Practice address
- 3630 E Louise Dr
Meridian, ID 83642-7975 - Phone
- (208) 377-9515
- Fax
- (208) 377-9517
- NPI assigned
- Aug 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3630 E Louise Dr
Meridian, ID 83642-7975
Mailing address
3630 E Louise Dr
Meridian, ID 83642-7975
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1871749408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 E LOUISE DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836427975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 E LOUISE DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836427975",
"telephone_number": "208-377-9515",
"fax_number": "208-377-9517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-14",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.