NPI age
20 years
Enumerated 2005-11-02
● Active Type 2 · Organization
Saint Alphonsus Nephrology
Saint Alphonsus Nephrology is 1 of 46 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jacobs
Accounts Receivable Manager
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 46 active clinic/center providers in Idaho.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
2303 Park Ave
Burley, ID 833182106
Mailing address
5610 Gage St, Suite B
Boise, ID 837061349
Authorized official
Jan M Jacobs
Accounts Receivable Manager
📞 2083673076
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Tyler Earl, COTA/L Occupational Therapy Assistant NPI 1033654900
- Shaylynn Smith, FNP-C Nurse Practitioner NPI 1013764224
- Bethany Walton, OTR/L Occupational Therapist NPI 1538690805
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 3 individual providers 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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.