NPI age
2 years
Enumerated 2024-02-09
● Active
Type 1 · Individual
Matthew Aaron Douglass, PMHNP
Douglass is 1 of 23 nurse practitioner providers in Idaho Falls and 1 of 374 in Idaho.
Primary specialty
Nurse Practitioner
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2026-04-15
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 374 active nurse practitioner providers in Idaho.
NPI age
2 years
↓ 2 yr below median (4 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
34% of peers hold subspecialties
NPI lifetime · 2024 → 2026
2024-02Enumerated in NPPES
2024
2026
Where they practice
Practice location
1248 E 17th St
Idaho Falls, ID 834046126
Mailing address
1248 E 17th St
Idaho Falls, ID 834046126
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.