Individual provider Active NPI

Liliya Yanyk

  • General Practice Registered Nurse
  • Star, ID
National Provider Identifier
1215805866
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
7671735 Issued in ID
Practice address
12635 W Gambrell St
Star, ID 83669-5142
Phone
(208) 912-2892
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X 7671735 ID Primary

Addresses

Primary practice location

12635 W Gambrell St
Star, ID 83669-5142

Mailing address

12635 W Gambrell St
Star, ID 83669-5142
Phone (208) 912-2892

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

State licenses

LicenseStateTypeSpecialty
7671735IDMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1215805866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 W GAMBRELL ST",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695142",
            "telephone_number": "208-912-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 W GAMBRELL ST",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695142",
            "telephone_number": "208-912-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANYK",
        "first_name": "LILIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "ID",
            "license": "7671735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Star, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.