Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carl Ryan Andrus, PA

Individual provider Physician Assistant · NPI 1215949532

Carl Ryan Andrus, PA is a Physician Assistant in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4902 W State St
Boise, ID 83703-3326
Phone: (208) 853-3100
Fax: (208) 853-3120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-508 (ID)

Record details

NPI number1215949532
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 13, 2006
Last updated in NPPESJuly 8, 2007

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