Individual provider Active NPI

Kristy Anne Kuehfuss, PH.D.

  • Clinical Psychologist
  • Lewiston, ID
National Provider Identifier
1114102274
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-202443 Issued in ID
Practice address
1418 Grelle Ave
Lewiston, ID 83501-5830
Phone
(208) 631-5843
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY-60894795 WA
Clinical Psychologist 103TC0700X PSY-202443 ID Primary

Addresses

Primary practice location

1418 Grelle Ave
Lewiston, ID 83501-5830

Mailing address

1418 Grelle Ave
Lewiston, ID 83501-5830
Phone (208) 631-5843

Other practice location 1

111 Bever Grade Road
Lapwai, ID 83540
Phone (208) 843-2274 ext. 2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100616000879 ID Practitioner - Clinical Psychologist 1557491651 Reassigns benefits to 1 organization
I20120801000492 TX Practitioner - Clinical Psychologist 1557491651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1418 Grelle Ave
Lewiston, ID 83501-5830
Phone (208) 631-5843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY-60894795WAMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: kristyk@nimiipuuhealth.directbygreenway.com

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1114102274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 GRELLE AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015830",
            "telephone_number": "208-631-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 GRELLE AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015830",
            "telephone_number": "208-631-5843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Bever Grade Road",
            "address_purpose": "LOCATION",
            "city": "Lapwai",
            "state": "ID",
            "postal_code": "83540",
            "country_code": "US",
            "telephone_number": "208-843-2274 x2885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUEHFUSS",
        "first_name": "KRISTY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY-60894795",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-202443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.