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

Nathan Gillis, DO

Individual provider Internal Medicine Physician · NPI 1144699505

Nathan Gillis, DO is an Internal Medicine in Boise, Idaho. Qualified in 2015, 11 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho and Texas.

Years since qualifying
11
Licensed in
ID, TX
In the registry since
2015
Specialties on file
2
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

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-5015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 221 Third St, Jbsa - Randolph, TX 78150 — (210) 652-8544
  • 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 — (210) 292-6225

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence O-1131 (ID)
Internal Medicine Physician Taxonomy 207R00000X · Licence BP10053699 (TX)

Record details

NPI number1144699505
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 16, 2015
Last updated in NPPESMay 15, 2020
Certification dateMay 15, 2020
Mailing address1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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