Individual provider Active NPI

Kaitlin Renette Munns, APRN-CNP

  • Family Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1083498554
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77909 Issued in ID
Practice address
625 Pole Line Rd W Ste 2a
Twin Falls, ID 83301-4270
Phone
(208) 814-8600
Fax
(208) 814-8942
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 77909 ID Primary

Addresses

Primary practice location

625 Pole Line Rd W Ste 2a
Twin Falls, ID 83301-4270

Mailing address

625 Pole Line Rd W Ste 2a
Twin Falls, ID 83301-4270
Phone (208) 814-8600

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
I20240220003916 ID Practitioner - Nurse Practitioner 1153765946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

625 Pole Line Rd W
Suite 2a
Twin Falls, ID 83301-4270
Phone (208) 814-8600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Clinic LLC CurrentSince Jan 7, 2024 Accepting new patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

980 Burley Ave
Ste 2A
Buhl, ID 83316

625 Pole Line Rd W
Ste 2A
Twin Falls, ID 83301
Phone (208) 814-8600

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1083498554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 POLE LINE RD W STE 2A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014270",
            "telephone_number": "208-814-8600",
            "fax_number": "208-814-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 POLE LINE RD W STE 2A",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014270",
            "telephone_number": "208-814-8600",
            "fax_number": "208-814-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNNS",
        "first_name": "KAITLIN",
        "middle_name": "RENETTE",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-11-06",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "77909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.