Organization Active NPI

Complete Embodiment Wellness

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1932811296
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
COMPLETE EMBODIMENT WELLNESS
Practice address
7683 W Emerald St
Boise, ID 83704-9018
Phone
(208) 376-2522
NPI assigned
Dec 19, 2022
Last updated
May 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Toni Bennett
Title
Credentialing Specialist
Phone
(208) 810-2319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

7683 W Emerald St
Boise, ID 83704-9018

Mailing address

PO Box 44124
Boise, ID 83711-0124
Phone (208) 384-9022

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brittany.a@boiseosteopathic.com Direct

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2276240Complete Embodiment Wellness7683 W Emerald St, Boise, ID 83704Certificate of waiverFeb 5, 2027

National Provider Directory

National Provider Directory

Locations

7683 W Emerald St
Boise, ID 83704
Phone (208) 376-2522

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1932811296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44124",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110124",
            "telephone_number": "208-384-9022",
            "fax_number": "208-947-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7683 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049018",
            "telephone_number": "208-376-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE EMBODIMENT WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "208-810-2319"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brittany.a@boiseosteopathic.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7683 W Emerald St",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837049018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.