OrganizationActive
Add Clinic of Idaho
NPI 1801567029 · Family Nurse Practitioner · Meridian, ID
Provider details
- NPI number
- 1801567029
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Cody Mattingly, Owner(858) 207-8861
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1450 W Ustick Rd
Unit 102
Meridian, ID 83646
Phone: (858) 207-8861
Street-level locationGet directions
Mailing address
330 W Anton Dr
Meridian, ID 83646-2066
Registry dates
- Enumerated
- 2021-09-27
- Last updated
- 2021-09-27
- Certified
- 2021-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.