Individual provider Active NPI

Kamlyn Harker, PA

  • Physician Assistant
  • Ammon, ID
National Provider Identifier
1104581537
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3067 Eagle Dr
Ammon, ID 83406-1273
Phone
(208) 522-4600
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3067 Eagle Dr
Ammon, ID 83406-1273

Mailing address

3067 Eagle Dr
Ammon, ID 83406-1273
Phone (208) 522-4600

Other names 1

  • Kamlyn Rogers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Just 4 Kids Pediatrics CurrentSince Dec 8, 2024 Accepting new patients
Cristina Leon, DO PA CurrentSince Feb 6, 2022 Accepting new patients

Locations

3067 Eagle Dr
Ammon, ID 83406
Phone 2085224600 ext. 105

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFGAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1104581537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKER",
        "first_name": "KAMLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-02-02",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMLYN",
            "last_name": "ROGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.