Raemi Dawn Nolevanko, FNP-C

Primary specialty

Occupational Health Nurse PractitionerTaxonomy code 363LX0106X

License

56430 Issued in ID

Practice address

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Phone

(208) 814-1000

NPI assigned

Feb 8, 2023

Last updated

Aug 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• St Luke's Magic Valley Regional Medical Center LTD

  dba St Lukes Retail Pharmacy Twin Falls

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1063119212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 E 3810 N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015549",
            "telephone_number": "208-731-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 POLE LINE RD W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015810",
            "telephone_number": "208-814-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 5th Ave W",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833381824",
            "country_code": "US",
            "telephone_number": "208-814-9840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLEVANKO",
        "first_name": "RAEMI",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "ID",
            "license": "56430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad J Nielson, D.C.
• Ryan Matthew Nielson, DDS
• Andrew W Nistler
• Cynthia M Nixon, LMSW
• Kurtis Wayne Nokes, PHARMD
• Heather McDonald Nope, PA-C
• Norco, Inc.
• Barry Evan Norman, M.D.
• Timothy J Norris, M.D.
• North Canyon Medical Center Inc. (North Canyon Surgery Center)

• Occupational Health Nurse Practitioner in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Occupational Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.