Kimberly A Kleaveland, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

66267 Issued in ID

Practice address

3525 E Louise Dr Ste 500
Meridian, ID 83642-6305

Phone

(208) 706-7050

Fax

(208) 706-7059

NPI assigned

Aug 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly A Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkleaveland1564303@direct.trinity-health.org
• Direct secure messaging: highlakesshevlin@praxismedicalgroup.directbygreenway.com

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

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1043569437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-367-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR STE 500",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426305",
            "telephone_number": "208-706-7050",
            "fax_number": "208-706-7059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 N Curtis Rd Ste 403",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061342",
            "country_code": "US",
            "telephone_number": "208-367-6225",
            "fax_number": "208-367-6279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2175 NW Shevlin Park Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977037101",
            "country_code": "US",
            "telephone_number": "541-389-7741",
            "fax_number": "541-278-8375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Bucknam Rd",
            "address_2": "Suite 2B",
            "address_purpose": "LOCATION",
            "city": "Falmouth",
            "state": "ME",
            "postal_code": "041051392",
            "country_code": "US",
            "telephone_number": "207-781-1600",
            "fax_number": "207-781-1609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-367-6225",
            "fax_number": "208-367-6279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEAVELAND",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201505347NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JOHNSON",
            "middle_name": "A",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Savannah Kisling- Scrima, PT, DPT
• Brian Craig Kitamura, M.D.
• Brian Dennis Kittelson, DNP, ARNP, FNP-C
• Colleen Gray Klabo, PSYD
• Vanessa M Klaus, FNP
• Eric W Klein, M.D.,MPH, TM
• Kelly Marie Klinger, COTA/L
• Jack D Klure, DDS
• KMB Home Care, LLC
• Ronald Knapp

• Family Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.