WILDFLOWER OBGYN LLC
NPI 1164300216
Obstetrics & Gynecology in Boise, ID

Q: What is Wildflower Obgyn LLC's NPI number?

The NPI number for Wildflower Obgyn LLC is 1164300216. It was assigned to this organization in the NPPES registry on August 26, 2025.

Q: What is Wildflower Obgyn LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since August 26, 2025CLIA 13D2336289 · Waiver

341 E BANNOCK ST, BOISE, ID 83712(208) 279-1099 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Wildflower Obgyn Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILDFLOWER OBGYN LLC (NPI 1164300216) is a healthcare organization registered as an obstetrics & gynecology in Boise, Idaho and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through December 29, 2027 and lists Jennifer Hudson, Owner / Do, as its authorized official.

NPPES Registry Identity

NPI1164300216

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameWILDFLOWER OBGYN LLC

Location Address341 E BANNOCK STBoise, ID 83712-6208

Mailing Address341 E Bannock StBoise, ID 83712-6208 · (208) 279-1099

Phone(208) 279-1099

Organization SubpartNo

Authorized OfficialJennifer HudsonOwner / Do · (208) 279-1098

Enumeration DateAugust 26, 2025

Last NPPES UpdateDecember 8, 2025

NPPES CertifiedDecember 8, 2025

✔ NPI 1164300216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

341 E BANNOCK ST, Boise, ID 83712

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wildflower Obgyn Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wildflower Obgyn LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Hudson, D.O.

Obstetrics/Gynecology

NPI 1265627319

90 HOPE DR 366 MEDICAL GROUP, WOMEN'S HEALTH
Mountain Home A F B, ID 83648

(208) 282-7567

✔ PECOS41 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2336289

Wildflower Obgyn, LLC · Boise, ID

Active · expires Dec 29, 2027

CLIA Number13D2336289

Laboratory TypePhysician Office

Certificate Effective DateDecember 30, 2025

Certificate Expiration DateDecember 29, 2027

Laboratory DirectorJennifer L. Hudson

Laboratory Phone(208) 279-1098

Laboratory LocationWildflower Obgyn, LLC341 E Bannock, Boise, ID 83712

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wildflower Obgyn LLC's NPI number?

The NPI number for Wildflower Obgyn LLC is 1164300216. It was assigned to this organization in the NPPES registry on August 26, 2025.

Where is Wildflower Obgyn LLC located?

Wildflower Obgyn LLC is located at 341 E Bannock St, Boise, ID 83712. The listed phone number is (208) 279-1099.

What is Wildflower Obgyn LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Wildflower Obgyn LLC enrolled in Medicare?

Yes. Wildflower Obgyn LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wildflower Obgyn LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Wildflower Obgyn LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wildflower Obgyn LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2336289) is associated with this NPI, valid through December 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wildflower Obgyn LLC was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.