Active NPI
Kayla Ockerse
- Obstetrics & Gynecology Physician
- Meridian, ID
National Provider Identifier
1104575836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 1381019
- Practice address
- 520 S Eagle Rd Ste 3213
Meridian, ID 83642-6356 - Phone
- (208) 706-3220
- Fax
- (208) 706-3221
- NPI assigned
- Mar 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 1381019 | ID | Primary |
Addresses
Primary practice location
520 S Eagle Rd Ste 3213
Meridian, ID 83642-6356
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1104575836",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S EAGLE RD STE 3213",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426356",
"telephone_number": "208-706-3220",
"fax_number": "208-706-3221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OCKERSE",
"first_name": "KAYLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-21",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "ID",
"license": "1381019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.