Individual provider Active NPI

Devin Kenneth Wernette

  • Physician Assistant
  • Ammon, ID
National Provider Identifier
1285315671
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3456 E 17TH St Ste 190
Ammon, ID 83406-6749
Phone
(208) 524-2222
NPI assigned
Jul 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3456 E 17TH St Ste 190
Ammon, ID 83406-6749

Mailing address

3456 E 17TH St Ste 190
Ammon, ID 83406-6749
Phone (208) 524-2222

Other identifiers 1

IdentifierTypeStateIssuer
IDTPID009778MedicaidID

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
I20251025000602 ID Practitioner - Physician Assistant 6901395409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simpson Dermcare and Family Medicine PLLCGroup PAC ID 1355656307, 6 clinicians

Practice addresses (Care Compare)

3456 E 17TH St
Suite 190
Ammon, ID 83406-6749
Phone (208) 524-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Simpson Dermcare and Family Medicine PLLC Family Medicine CurrentSince Oct 15, 2025 Accepting new patients
New Dawn Counseling, LLC PastSince Aug 10, 2025 Accepting new patients

Locations

3456 E 17th St
Ste 190
Ammon, ID 83406
Phone (208) 524-2222

Organizations & group practices 2

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1285315671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 E 17TH ST STE 190",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066749",
            "telephone_number": "208-524-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 E 17TH ST STE 190",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066749",
            "telephone_number": "208-524-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNETTE",
        "first_name": "DEVIN",
        "middle_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID009778",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.