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NORTHSTAR HEALTHCARE LLC NPI 1598849051


NPI Information

NPI: 1598849051
Provider Name: NORTHSTAR HEALTHCARE LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization

CLIA Number: 13D1023169

Address:
1995 E 17TH ST
STE 2
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 529-2352
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NORTHSTAR HEALTHCARE LLC is a nurse practitioner in Idaho Falls, ID. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. NORTHSTAR HEALTHCARE LLC NPI is 1598849051. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1995 E 17TH ST
STE 2
IDAHO FALLS, ID
ZIP 83404-493
Phone: (208) 529-2352
Fax: (208) 528-3332

The provider's authorized official is Laura J. Mason .
The authorized official title is Owner/fnpc and has the following contact phone number (208) 529-2352.

The CLIA number assigned to this NPI record is 13D1023169 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/24/2006 and was last updated on 2/3/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerNo
2363L00000XNurse PractitionerNP386AIDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1806924200MEDICAIDIDAHO
2DC1808OTHERRAILROAD MEDICARE
3S88529MEDICARE UPIN
4807185300MEDICAIDIDAHO
51376852MEDICARE PINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.