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OLDE TOWN MEDICAL
NPI 1245690544
Nurse Practitioner - Adult Health in Meridian, ID

Active since February 29, 2016
124 E PINE AVE, MERIDIAN, ID 83642(208) 887-5422(208) 888-6297 Get Directions Write a Review

NPPES record last updated: March 11, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Olde Town Medical NPPES

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

OLDE TOWN MEDICAL (NPI 1245690544) is a healthcare organization registered as an adult health in Meridian, Idaho and active in the NPI registry since February 2016. The organization lists Susan E Tomey, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1245690544
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameOLDE TOWN MEDICAL
Location Address124 E PINE AVEMeridian, ID 83642-2331
Mailing Address124 E Pine AveMeridian, ID 83642-2331 · (208) 887-5422 · Fax (208) 888-6297
Phone(208) 887-5422
Fax(208) 888-6297
Organization SubpartNo
Authorized OfficialSusan E TomeyProvider/owner · (208) 888-5422
Enumeration DateFebruary 29, 2016
Last NPPES UpdateMarch 11, 2016
✔ NPI 1245690544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
124 E PINE AVE, Meridian, ID 83642
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Other Identifiers 1

OtherNP-735AID · Idaho Np License

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

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 Olde Town Medical's NPI number?

The NPI number for Olde Town Medical is 1245690544. It was assigned to this organization in the NPPES registry on February 29, 2016.

Where is Olde Town Medical located?

Olde Town Medical is located at 124 E Pine Ave, Meridian, ID 83642. The listed phone number is (208) 887-5422.

What is Olde Town Medical's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Olde Town Medical was last updated on March 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.