Individual provider Active NPI

Christine Cooper

  • Primary Care Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1891176798
Registry record updated Aug 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP-1575A Issued in ID
Practice address
63 W Willowbrook Dr
Meridian, ID 83646-1656
Phone
(208) 888-7877
NPI assigned
Jun 16, 2015
Last updated
Aug 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP-1575A ID Primary

Addresses

Primary practice location

63 W Willowbrook Dr
Meridian, ID 83646-1656

Mailing address

3467 W Muirfield Dr
Meridian, ID 83646-4162

Other identifiers 1

IdentifierTypeStateIssuer
NP-1575AOtherIDIDAHO BOARD OF NURSING

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
I20150812009000 ID Practitioner - Nurse Practitioner 1850606369 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1575AIDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jan 6, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jan 6, 2023 Accepting new patients
Preventative Health CurrentSince Dec 10, 2022 Accepting new patients
Key Stone Health Care CurrentSince Aug 1, 2015 Accepting new patients
Keystone Hospice, LLC PastSince Aug 11, 2019 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

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

1079 S Ancona Ave
Ste 100
Eagle, ID 83616
Phone (208) 853-2273

21 N Fisher Park Way
Eagle, ID 83616
Phone (208) 514-0670

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

9951 W St Lukes Dr
Nampa, ID 83687
Phone (208) 463-6006

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755388800000",
    "number": "1891176798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3467 W MUIRFIELD DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 W WILLOWBROOK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461656",
            "telephone_number": "208-888-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "NP-1575A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO BOARD OF NURSING",
            "identifier": "NP-1575A",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.