Organization Active NPI

East Meets West Medical Clinic

  • Family Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1982299103
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
EAST MEETS WEST MEDICAL CLINIC
Practice address
353 W Iowa Ave
Nampa, ID 83686-2856
Phone
(480) 430-3530
NPI assigned
Mar 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Tyle Watkins, DNP
Title
Owner
Phone
(480) 430-3530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

353 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

3873 E Renwick St
Meridian, ID 83642-6486
Phone (480) 430-3530

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://webservice.kareo.com/services/soap/2.1/

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
13D2215325East Meets West Medical Clinic353 W Iowa St, Nampa, ID 83686Certificate of waiverMar 1, 2027

National Provider Directory

National Provider Directory

Locations

3764 E Amity Ave
Ste 103
Nampa, ID 83687
Phone (208) 891-2201

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1982299103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3873 E RENWICK ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426486",
            "telephone_number": "480-430-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "480-430-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MEETS WEST MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "TYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-430-3530",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://webservice.kareo.com/services/soap/2.1/",
            "affiliation": "N",
            "address_1": "353 W Iowa Ave",
            "city": "Nampa",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836862856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.