Individual provider Active NPI

Rachel Porter, FNP-C

  • Family Nurse Practitioner
  • Hayden, ID
National Provider Identifier
1255118196
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66465 Issued in ID
Practice address
8181 N Cornerstone Dr
Hayden, ID 83835-8752
Phone
(078) 520-8772
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66465 ID Primary

Addresses

Primary practice location

8181 N Cornerstone Dr
Hayden, ID 83835-8752

Mailing address

333 E Penrose Ave
Post Falls, ID 83854-0246

Other names 1

  • Rachel Gallegos Former name

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
I20231102001605 ID Practitioner - Nurse Practitioner 5991151557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Professional AssociatesGroup PAC ID 6305812017, 8 clinicians

Practice addresses (Care Compare)

8181 N Cornerstone Dr
Hayden Lake, ID 83835-8752
Phone (208) 772-0785

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66465IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Professional Associates CurrentSince Dec 1, 2023 Accepting new patients

Locations

8181 N Cornerstone Dr
Hayden Lake, ID 83835
Phone (208) 772-0785

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1255118196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E PENROSE AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838540246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 N CORNERSTONE DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358752",
            "telephone_number": "078-520-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "RACHEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "GALLEGOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.