Individual provider Active NPI

Stacey Lynn Adan, CST

  • Surgical Assistant
  • Boise, ID
National Provider Identifier
1962367029
Registry record updated Feb 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
8800 W Emerald St
Boise, ID 83704-8205
Phone
(208) 373-5000
NPI assigned
Dec 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Primary

Addresses

Primary practice location

8800 W Emerald St
Boise, ID 83704-8205

Mailing address

16 S Bingham St
Nampa, ID 83651-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771718400000",
    "number": "1962367029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S BINGHAM ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836517650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048205",
            "telephone_number": "208-373-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-22",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.