Michael Scott Womack, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

M-8136 Issued in ID

Practice address

341 E Bannock St
Boise, ID 83712-6208

Phone

(208) 453-9962

Fax

(208) 453-9963

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment NPD
• Pediatric Cardiology of Idaho

  • Pediatric Cardiology Physician
  • Boise, ID
  • NPI 1376362038
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD
• Magic Valley Regional Medical Center

  • Psychiatric Hospital
  • Twin Falls, ID
  • NPI 1447208947
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1912950338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E SOLITUDE CT",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127576",
            "telephone_number": "208-453-9962",
            "fax_number": "208-453-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126208",
            "telephone_number": "208-453-9962",
            "fax_number": "208-453-9963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 N Liberty St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048729",
            "country_code": "US",
            "telephone_number": "208-453-9962",
            "fax_number": "208-453-9963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-8136",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "ID",
            "license": "M-8136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelin Wollner, ATC
• Matthew James Wolter, DO
• Mindy Jo Wolverton, LMSW
• Sarah Margaret Wolverton, D.C.
• Delainey Mae Womack, RDN
• Woman'S Clinic
• Women'S and Children'S Alliance
• Women'S and Children'S Alliance
• Women'S and Children'S Alliance
• Women'S Health Associates, PLLC

• Pediatric Cardiology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Cardiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.