NPI age
19 years
Enumerated 2007-01-16
● Active
Type 1 · Individual
Elmer G Dodge JR., FNP
Dodge is 1 of 2 nurse practitioner providers in Star and 1 of 658 in Idaho.
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-09-01
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 658 active nurse practitioner providers in Idaho.
NPI age
19 years
↑ 11 yr above median (8 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
1
In the 34% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Practice location
9858 W State St
Star, ID 836695210
Mailing address
Po Box 44267
Boise, ID 837110267
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...
-
Registered NurseDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | NPQP7 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010150031 | REGENCE BLUE SHIELD OF ID |
| 05 (ID) | 806045400 |
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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- 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.
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