NPI age
18 years
Enumerated 2008-05-21
● Active Type 2 · Organization
Mountain States Oncology Group
Mountain States Oncology Group is 1 of 658 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Sullivan
Business Administrator
Last NPPES update
2008-05-21
Source: monthly bulk 2026-05
How this organization compares
Across 658 active nurse practitioner providers in Idaho.
NPI age
18 years
↑ 10 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-05Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
210 W Jefferson St
Boise, ID 837026044
Mailing address
Po Box 1809
Boise, ID 837011809
Authorized official
Joni Sullivan
Business Administrator
📞 2083433223
Individual providers at this organization
1 individual provider on file at this primary practice address.
- C Sullivan, M.D. Specialist NPI 1649453903
Specialties
-
Nurse Practitioner Primary(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...
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.