Organization Active NPI

Triton Wellness Solutions & Softwave Therapy

  • Nurse Practitioner
  • Chubbuck, ID
National Provider Identifier
1992408678
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TRITON WELLNESS SOLUTIONS & SOFTWAVE THERAPY
Practice address
210 W Burnside Ave Ste D
Chubbuck, ID 83202-4916
Phone
(208) 252-5566
NPI assigned
Mar 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Scott Bradley Schaffer, FNPNPI 1720410012
Title
Owner
Phone
(208) 850-9125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

210 W Burnside Ave Ste D
Chubbuck, ID 83202-4916

Mailing address

210 W Burnside Ave Ste D
Chubbuck, ID 83202-4916
Phone (208) 252-5566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231129001044 ID Part B Supplier - Clinic/Group Practice 8820446032 Receives reassigned benefits from 1 practitioner
Practice locations: Chubbuck, ID

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
13D2300695Triton Wellness Solutions210 W Burnside Ave Ste D, Chubbuck, ID 83202Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory

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": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1992408678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE STE D",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-252-5566",
            "fax_number": "208-213-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE STE D",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-252-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRITON WELLNESS SOLUTIONS & SOFTWAVE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-850-9125",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.