Aaron Ackerson, ACNPC-AG

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

9571036 Issued in ID

Practice address

190 E Bannock St
Boise, ID 83712-6241

Phone

(208) 381-5500

Fax

(208) 381-2555

NPI assigned

Oct 5, 2022

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, ID2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aackersonaprn388393@carlehiedirect.net

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  dba Methodist Medical Group

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - Trinity Mountain

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1982329751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-5500",
            "fax_number": "208-381-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 W Northland Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616144950",
            "country_code": "US",
            "telephone_number": "815-876-6349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACKERSON",
        "first_name": "AARON",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61290133",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209025003",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "202209977NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ID",
            "license": "9571036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Achieve, LLC
• Acjcs
• Daniel Bryan Ackerman, DMD
• Jerrod Ackerman
• Robert Ackerman, D.D.S.
• Matthew Ryan Ackley, PMHNP
• Nicole Lynn Ackley, PHYSICIAN ASSISTANT
• Acme Markets Inc (Acme Pharmacy)
• Acme Markets Inc (Acme & Sav-on Pharmacy)
• Lena Acosta, LPC

• Acute Care Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Acute Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.