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

Taylor Vickers, PA-C

Individual provider Basic Emergency Medical Technician · NPI 1164046702

Taylor Vickers, PA-C is a Physician Assistant in Nampa, Idaho. Graduated from University of Texas Medical Branch at Galveston in 2020, 6 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Texas.

Years since qualifying
6
Trained at
University of Texas Medical Branch at Galveston
Licensed in
ID, TX
In the registry since
2020
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone: (208) 205-7282
Fax: (208) 205-7591
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6720 Bertner Ave, Houston, TX 77030-2604 — (832) 355-1000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4161079 (ID)
Basic Emergency Medical Technician Taxonomy 146N00000X · Licence 745200 (TX)
Physician Assistant Taxonomy 363A00000X · Licence PA13966 (TX)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA13966 (TX)

Record details

NPI number1164046702
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 29, 2020
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare