Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Cody J Scrivner, PA-C

Individual provider Physician Assistant · NPI 1134671894

Mr. Cody J Scrivner, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2016, 10 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
10
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10798 W Overland Rd
Boise, ID 83709-1329
Phone: (208) 377-3368
Fax: (208) 322-4691
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1134671894
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 28, 2016
Last updated in NPPESOctober 28, 2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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