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NPI 1730714049ActiveOrganization· Nurse Practitioner, Primary Care· Eagle, ID
Nurse Practitioner, Primary Care in Eagle, Idaho, registered in NPPES in March 2020. The authorized official on file is Mary Roehling, Nurse Practitioner / Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1730714049 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 6, 2020 |
| Last updated in NPPES | Mar 18, 2020 |
| Certified by provider | Mar 18, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|