Active NPI
Kathrin Bodine, NP
- Family Nurse Practitioner
- Boise, ID
National Provider Identifier
1124734553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 65244
- Practice address
- 2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483 - Phone
- (208) 495-4145
- Fax
- (833) 740-4395
- NPI assigned
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 65244 | ID | Primary |
Addresses
Primary practice location
2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483
Mailing address
2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483
Phone (208) 495-4145
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65244 | Other | ID | IDAHO APRN LICENSE / IDAHO STATE BOARD OF NURSING |
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 5, 2024 through Dec 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750809600000",
"number": "1124734553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2242 E RIVERWALK DR STE 200",
"city": "BOISE",
"state": "ID",
"postal_code": "837065483",
"telephone_number": "208-495-4145",
"fax_number": "833-740-4395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2242 E RIVERWALK DR STE 200",
"city": "BOISE",
"state": "ID",
"postal_code": "837065483",
"telephone_number": "208-495-4145",
"fax_number": "833-740-4395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODINE",
"first_name": "KATHRIN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-30",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "65244",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO APRN LICENSE / IDAHO STATE BOARD OF NURSING",
"identifier": "65244",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.