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

Dr. Shae Hal Johnson, DO

Individual provider Family Medicine Physician · NPI 1669588315

Dr. Shae Hal Johnson, DO is a Family Practice in Boise, Idaho. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2004, 22 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho, Oregon and Utah.

Years since qualifying
22
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
ID, OR, UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

6533 Emerald St
Boise, ID 83704-8737
Phone: (208) 302-5100
Fax: (208) 302-5155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-0870 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence 5960250-1204 (UT)
Family Medicine Physician Taxonomy 207Q00000X · Licence DO27594 (OR)

Record details

NPI number1669588315
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedAugust 22, 2006
Last updated in NPPESNovember 10, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2004 (22 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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