Katlin Nicole Foote, FNP
Individual provider Active NPI Family Nurse Practitioner · Fruitland, ID
NPI 1013493576 · NPPES record last updated Dec 29, 2023
Key facts
- NPI
- 1013493576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 59250 (ID)
- Practice address
- 910 NW 16TH St
Ste 101
Fruitland, ID 83619 - Phone
- (208) 452-8000
- Fax
- (208) 452-8055
- NPI assigned
- Jul 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Alphonsus Medical Center- Ontario Inc
Practice addresses (Care Compare)
910 NW 16TH St
Fruitland, ID 83619-2265
Hospital & facility affiliations
- Enhabit Home Health of Western Idaho
- Saint Alphonsus Medical Center Ontario
- Saint Alphonsus Regional Medical Center
- Saint Alphonsus Medical Center - Nampa
- St Luke'S Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190107002222 | ID | Practitioner - Nurse Practitioner | 3274879622 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59250 | ID | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Medical Center- Ontario Inc | Current |
Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current |
Accepting new patients |
Locations
910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000
3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59250 | ID | Yes |
Addresses
Primary practice location
910 NW 16TH St
Ste 101
Fruitland, ID 83619
Mailing address
3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 452-8000
Other providers in Fruitland, ID
- Evergreen Prosthetics and Orthotics, LLC
- Patricia Marie Fagen
- Katherine Hollie Fisher
- Laura Dolores Foley
- John D Foote
- Elizabeth Frasier
- Bradi Fritts
- Fruitland Chiropractic PLLC
- Fruitland Orthopedic Clinic
- Fulleton Counseling
All providers in Fruitland, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.