DR. JON PARKER WAGNILD MD NPI 1164459541

NPI Information

  • NPI: 1164459541
  • Provider Name: DR. JON PARKER WAGNILD, MD
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • Address: 5610 GAGE ST
    SUITE A
    BOISE, ID
    ZIP 83706
  • Phone: (208) 367-3370

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NPI Details

DR. Jon Parker Wagnild, MD is a nephrology internal medicine in Boise, ID. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Jon Parker Wagnild, MD NPI is 1164459541. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5610 GAGE ST
SUITE A
BOISE, ID
ZIP 83706-349
Phone: (208) 367-3370

The enumeration date for this NPI number is 6/28/2006 and was last updated on 7/8/2007.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyM4213IDAHOYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B63460MEDICARE UPINIDAHO

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: 3/30/2025

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