Individual provider Active NPI

Kacey E Mueller

  • Community/Behavioral Health Agency
  • Boise, ID
National Provider Identifier
1043859002
Registry record updated Dec 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
688 N Avenue H Apt 304
Boise, ID 83712-6471
Phone
(208) 863-6354
NPI assigned
Dec 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

688 N Avenue H Apt 304
Boise, ID 83712-6471

Mailing address

688 N Avenue H Apt 304
Boise, ID 83712-6471
Phone (208) 863-6354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1576972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576972800000",
    "number": "1043859002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 N AVENUE H APT 304",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126471",
            "telephone_number": "208-863-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 N AVENUE H APT 304",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126471",
            "telephone_number": "208-863-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KACEY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-22",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.