Rebecca L Klingler, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2861266 Issued in ID

Practice address

421 Memorial Dr
Pocatello, ID 83201-4008

Phone

(208) 234-7900

Fax

(208) 236-6328

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca Wood Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canvi Behavioral Health PLLCGroup PAC ID 0941692073, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Canvi Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
  • NPI 1144984873
  Medicare reassignment Care Compare group NPD
• Optimum Health, PLLC

  • Emergency Medicine Physician
  • Pocatello, ID
  • NPI 1306401575
  Medicare reassignment NPD

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1235624834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-234-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-234-7900",
            "fax_number": "208-236-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGLER",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "2861266",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "ID",
            "license": "N-49659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WOOD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elisabeth Gayle Kinghorn, P.A.
• Gilson Peter Kingman
• Zachary Kinney, RECOVERY COACH
• Kinport Physical Therapy
• Melissa Kjos, M.D.
• Steven R Klitgaard, PT
• Daniel M Knapp, LCSW
• Derek Curt Knapp, DPM
• Kenneth Michael Knapp, CRNA
• Tonja Knapp, RN

• Psychiatric/Mental Health Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.