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SAGE HEALTHCARE PLLC NPI 1891820767


NPI Information

NPI: 1891820767
Provider Name: SAGE HEALTHCARE PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
413 N ALLUMBAUGH ST
STE 101
BOISE, ID
ZIP 83704
Phone: (208) 323-1125
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SAGE HEALTHCARE PLLC is a family medicine in Boise, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SAGE HEALTHCARE PLLC NPI is 1891820767. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

413 N ALLUMBAUGH ST
STE 101
BOISE, ID
ZIP 83704-212
Phone: (208) 323-1125
Fax: (208) 323-9604

The provider's authorized official is Cheri Peterson .
The authorized official title is Credentialer and has the following contact phone number (208) 954-5594.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 4/20/2021.


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
1207Q00000XFamily MedicineYes
22084N0400XPsychiatry & NeurologyNeurologyNo
3363A00000XPhysician AssistantNo
4363AM0700XPhysician AssistantMedicalNo
5363LF0000XNurse PractitionerFamilyNo
6363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

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
1807468900MEDICAIDIDAHO

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

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