Nichole Blair Shumway, DO is a medicare enrolled "Internal Medicine" physician in Rupert, Idaho. She went to Des Moines University Of Osteopathic Medicine And Health Sciences and graduated in 2020 and has 6 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice St Lukes Clinic Llc, Minidoka Memorial Hospital and her current practice location is
1308 8th St, Rupert, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 436-4322.
Nichole Blair Shumway is licensed to practice in Idaho (license number O-1848) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1386263796.
Physician's Profile
| Full Name | Nichole Blair Shumway |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 6 Years |
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| Location | 1308 8th St, Rupert, Idaho |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Nichole Blair Shumway attended and graduated from Des Moines University Of Osteopathic Medicine And Health Sciences in 2020
NPI Data:
- NPI Number: 1386263796
- Provider Enumeration Date: 04/15/2020
- Last Update Date: 06/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 2769809417
- Enrollment ID: I20230912001070
Medical Identifiers
Medical identifiers for Nichole Blair Shumway such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1386263796 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | O-1848 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| St Lukes Clinic Llc | 1052217478 | 294 |
| Minidoka Memorial Hospital | 7315908894 | 30 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nichole Blair Shumway allows following entities to bill medicare on her behalf.
| Entity Name | St Lukes Clinic Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
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| Entity Name | Minidoka Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679553531 PECOS PAC ID: 7315908894 Enrollment ID: O20050801000086 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nichole Blair Shumway is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Nichole Blair Shumway, DO 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Nichole Blair Shumway, DO 1308 8th St, Rupert, ID 83350-1530 Ph: (208) 436-4322 |
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