P Praxis·MD
● Active Type 2 · Organization

Essential Life Boise, Llc

Clinic/Center·Boise, ID· NPI 1669727400 · Enumerated 2012 · 13 years on NPI
Essential Life Boise, Llc is 1 of 36 clinic/center organizations in Idaho.
NPI age
13 years
Enumerated 2012-07-18
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Fedewa
Owner
Last NPPES update
2012-07-18
Source: monthly bulk 2026-05

How this organization compares

Across 36 active clinic/center providers in Idaho.

NPI age
13 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2012 → 2026

2012-07Enumerated in NPPES
2012 2026

Where they practice

Primary practice location
13125 W Persimmon Ln, Suite 100
Boise, ID 83713
📞 2089910352
Mailing address
13125 W Persimmon Ln, Suite 100
Boise, ID 83713

Authorized official

Yvonne Fedewa
Owner
📞 2089910352

Individual providers at this organization

1 individual provider on file at this primary practice address.

Specialties

  • Clinic/Center Primary
    An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or...
    ID license #CHIA1466 taxonomy 261QM2500X

Practice context

Multi-provider organization. 1 individual provider on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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