Individual provider Active NPI

Cozette Jannel Koenig, FNP-C

  • Family Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1053285767
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5271285 Issued in ID
Practice address
16111 N Brinson St # 110
Nampa, ID 83687-5509
Phone
(208) 468-9400
NPI assigned
Oct 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5271285 ID Primary

Addresses

Primary practice location

16111 N Brinson St # 110
Nampa, ID 83687-5509

Mailing address

16111 N Brinson St # 110
Nampa, ID 83687-5509
Phone (208) 468-9400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251201003130 ID Practitioner - Nurse Practitioner 0749773570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gary Gregerson MD PAGroup PAC ID 3173838141, 10 clinicians

Practice addresses (Care Compare)

16111 N Brinson St
Suite 110
Nampa, ID 83687-5509
Phone (208) 468-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5271285IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Gregerson, M.D., P.a. CurrentSince Oct 22, 2025 Accepting new patients
Gary Gregerson MD PA PastSince Oct 5, 2025 Accepting new patients

Locations

1611 12th Ave Rd
Ste A
Nampa, ID 83686
Phone (208) 468-9400

16111 N Brinson St
#110
Nampa, ID 83687
Phone (208) 468-9400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1053285767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16111 N BRINSON ST # 110",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-468-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16111 N BRINSON ST # 110",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-468-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "COZETTE",
        "middle_name": "JANNEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "5271285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.