TREASURE VALLEY CARDIOLOGY PC NPI 1184657389

NPI Information

  • NPI: 1184657389
  • Provider Name: TREASURE VALLEY CARDIOLOGY PC
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • Address: 900 N LIBERTY ST
    SUITE 302
    BOISE, ID
    ZIP 83704
  • Phone: (208) 322-1686

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NPI Details

TREASURE VALLEY CARDIOLOGY PC is a cardiovascular disease internal medicine in Boise, ID. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. TREASURE VALLEY CARDIOLOGY PC NPI is 1184657389. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

900 N LIBERTY ST
SUITE 302
BOISE, ID
ZIP 83704-704
Phone: (208) 322-1686

The provider's authorized official is Graham Wetherley .
The authorized official title is President and has the following contact phone number (208) 322-1686.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 11/17/2014.

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
1363L00000XNurse PractitionerNP642AIDAHONo
2207RC0000XInternal MedicineCardiovascular DiseaseM5449IDAHOYes

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
1002180300MEDICAIDIDAHO
2807805900MEDICAIDIDAHO
31374726MEDICARE 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: 3/30/2025

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