Individual provider Active NPI

Keelin Marie Hines, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Coeur D Alene, ID
National Provider Identifier
1124766076
Registry record updated May 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
73673 Issued in ID
Practice address
3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone
(208) 620-5250
NPI assigned
May 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 61676296 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 73673 ID Primary

Addresses

Primary practice location

3700 W Seltice Way
Coeur D Alene, ID 83814-8921

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
I20220815003205 ID Practitioner - Nurse Practitioner 7214310846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73673IDMDPsychiatric/Mental Health Nurse Practitioner
61676296WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dirne Health Centers, Inc. CurrentSince Aug 2, 2022 Accepting new patients
Dirne Health Centers, Inc. Current Accepting new patients
Dirne Health Centers, Inc. CurrentSince Aug 2, 2022 Accepting new patients

Locations

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

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

1038 Northwest Blvd
Coeur D Alene, ID 83814
Phone (208) 620-5210

1221 W Ironwood Dr
Ste 100
Coeur D Alene, ID 83814
Phone (208) 620-5210

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

1090 W Park Pl
Ste B
Coeur D Alene, ID 83814
Phone (208) 292-0303

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: keelin.hines.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746316800000",
    "number": "1124766076",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W SELTICE WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838148921",
            "telephone_number": "208-620-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "KEELIN",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2025-05-04",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61676296",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "73673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.