Kalin Danial Lister, STUDENT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9871643 Issued in ID

Practice address

8971 W Overland Rd
Boise, ID 83709-1651

Phone

(208) 378-4288

Fax

(208) 378-4297

NPI assigned

Nov 25, 2024

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kalin.lister@phmg.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920
  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203
  NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1316183668
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1033935093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SUNRISE RIM RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836868325",
            "telephone_number": "208-912-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8971 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091651",
            "telephone_number": "208-378-4288",
            "fax_number": "208-378-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTER",
        "first_name": "KALIN",
        "middle_name": "DANIAL",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9871643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Lipscomb, M.S. LPC
• Jordan Lipsh
• Cassie Anne Lis, PT, DPT
• Crystal Angel Lish, LCSW
• Jordan Matthew List, PHARM.D.
• Jessica Litke
• Alishia Little, PA
• Bryan David Little, MD
• Janet Lynn Little, LCPC
• Kenneth M Little, MD

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.