Active NPI
Kathleen J Duffy, PA-C
- Physician Assistant
- Boise, ID
National Provider Identifier
1154301141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA452
- Practice address
- 1520 W State St
Ste 100
Boise, ID 83702-4038 - Phone
- (208) 947-7700
- Fax
- (208) 947-7701
- NPI assigned
- Jan 18, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA452 | ID | Primary |
Addresses
Primary practice location
1520 W State St
Ste 100
Boise, ID 83702-4038
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 947-7700
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Health Care Incorporated | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Meridian, ID
- NPI 1013955178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1154301141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-947-7700",
"fax_number": "208-947-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 W STATE ST",
"address_2": "STE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837024038",
"telephone_number": "208-947-7700",
"fax_number": "208-947-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFFY",
"first_name": "KATHLEEN",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA452",
"primary": true
}
],
"identifiers": [],
"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 Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.