Individual provider Active NPI

Jennifer Patchett

  • Psychiatric/Mental Health Nurse Practitioner
  • Boise, ID
National Provider Identifier
1942049606
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7571239 Issued in ID
Practice address
413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone
(208) 323-1125
NPI assigned
May 22, 2024
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7571239 ID Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 43784 ID

Addresses

Primary practice location

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219

Mailing address

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone (208) 323-1125

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
I20250124003534 ID Practitioner - Nurse Practitioner 9931638665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sage Healthcare PLLCGroup PAC ID 7810974904, 10 clinicians

Practice addresses (Care Compare)

413 N Allumbaugh St
Suite 101
Boise, ID 83704-9219
Phone (208) 323-1125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43784IDMDPsychiatric/Mental Health Registered Nurse
7571239IDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Healthcare PLLC Psychiatric/Mental Health CurrentSince Feb 1, 2025 Accepting new patients

Locations

413 N Allumbaugh St
Ste 101
Boise, ID 83704
Phone (208) 323-1125

Organizations & group practices 1

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1942049606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCHETT",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "7571239",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ID",
            "license": "43784",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.