Individual provider Active NPI

Kimberly Ann Ashmore, NP

  • Family Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1104581123
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77275 Issued in ID
Practice address
1090 W Park PL
Coeur D Alene, ID 83814-2785
Phone
(208) 215-2005
Fax
(844) 807-3782
NPI assigned
Nov 4, 2021
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 77275 ID Primary
Registered Nurse 163W00000X 39558 ID

Addresses

Primary practice location

1090 W Park PL
Coeur D Alene, ID 83814-2785

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299

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
I20230825001656 ID Practitioner - Nurse Practitioner 5597128454 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
Dirne Health Centers IncGroup PAC ID 2466353354, 82 clinicians

Practice addresses (Care Compare)

1090 W Park PL
Coeur D Alene, ID 83814-2785
Phone (208) 292-0290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39558IDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dirne Health Centers, Inc. CurrentSince Aug 11, 2023 Accepting new patients
Dirne Health Centers, Inc. Family Current Accepting new patients
Dirne Health Centers Inc Past Accepting new patients

Locations

1090 W Park Pl
Coeur D Alene, ID 83814
Phone (208) 215-2005

2205 N Ironwood Pl
Coeur D Alene, ID 83814
Phone (208) 292-0303

3700 W Seltice Way
Coeur D Alene, ID 83814
Phone (208) 620-5250

740 McKinley Ave
Kellogg, ID 83837
Phone (208) 783-1267

925 E Polston Ave
Post Falls, ID 83854
Phone (208) 618-0787

16760 N Highway 41
Rathdrum, ID 83858
Phone (208) 687-5627

120 S 13th St
St Maries, ID 83861
Phone (208) 245-4363

Interoperability endpoints

  • Direct secure messaging: kimberly.ashmore.1@16899.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1104581123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-215-2005",
            "fax_number": "844-807-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHMORE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "77275",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "39558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.