Nicholas Merrill Packer, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M12921 Issued in ID

Practice address

164 S 5TH St
Montpelier, ID 83254-1557

Phone

(208) 847-1110

Fax

(208) 847-0228

NPI assigned

May 2, 2011

Last updated

Jul 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Virginia Commonwealth University, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Canyon Medical Center IncGroup PAC ID 0941371439, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Canyon Medical Center Hospital, Gooding, ID, CCN 131302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.packer.1@17373.direct.athenahealth.com

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.

• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment Care Compare group NPD
• Bear Lake County Memorial Hospital

  dba Bear Lake Internal Medicine

  • Internal Medicine Physician
  • Montpelier, ID
  • NPI 1174741441
  Medicare reassignment NPD
• BMH, Inc.

  dba Bingham Memorial Physicians & Surgeons Center

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba CRMC Family Medicine

  • Multi-Specialty Clinic/Center
  • Burley, ID
  • NPI 1710156922
  Medicare reassignment NPD
• Ihc Health Services, Inc.

  dba Intermountain Health Cassia Regional Hospital

  • General Acute Care Hospital
  • Burley, ID
  • NPI 1497865315
  Medicare reassignment NPD
• BMH Inc.

  dba The Health and Wellness Sleep Institute of Pocatello

  • Nurse Practitioner
  • Pocatello, ID
  • NPI 1104332048
  NPD
• BMH, Inc.

  dba 1st Choice Urgent Care & Medical Center-Chubbuck

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD
• Ihc Health Services Inc

  dba Cassia Regional Hospital Physicians

  • Obstetrics & Gynecology Physician
  • Burley, ID
  • NPI 1043324585
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Gooding, ID
  • NPI 1275703241
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Imaging Center Twin Falls

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Pocatello Health Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
  • NPI 1154089126
  NPD
• Pocatello Health Services, LLC

  dba Portneuf Medical Practices

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1215165485
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Care Compare affiliation

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1891086377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 S 5TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541557",
            "telephone_number": "208-847-1110",
            "fax_number": "208-847-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 S 5TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541557",
            "telephone_number": "208-847-1110",
            "fax_number": "208-847-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "NICHOLAS",
        "middle_name": "MERRILL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT198975",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M12921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Joseph Nelson, MSW, LMSW
• Noall E Wolff MD
• Harold A Olson, RPH
• Olson's Modern Drug Co.
• Olympus Laboratories, LLC
• Joseph Edward Podany Jr., MD
• Jamie Prince Bartschi, MMT, MT-BC
• Reset P.a. (Bear Lake Family Chiropractic)
• Houston Reynolds, MD
• Anthony Stafford Ruud, PHARM-D

• Obstetrics & Gynecology Physician in Montpelier, ID
• Providers in Montpelier, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.