Organization Active NPI

Kim Christopher Knudson DO PLLC

  • Child & Adolescent Psychiatry Physician
  • Boise, ID
National Provider Identifier
1306724216
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
KIM CHRISTOPHER KNUDSON DO PLLC
Practice address
413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone
(208) 323-1125
NPI assigned
Aug 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Authorized official

Name
Kim Christopher Knudson, DO, MBANPI 1457885527
Title
Child & Adolescent Psychiatrist
Phone
(208) 221-8088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219

Mailing address

5310 W Maggio Dr
Meridian, ID 83646-7466
Phone (208) 221-8088

Other practice location 1

2131 S Bonito Way
Meridian, ID 83642-1659
Phone (208) 202-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260306002552 ID Part B Supplier - Clinic/Group Practice 8729565361 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1306724216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W MAGGIO DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467466",
            "telephone_number": "208-221-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S Bonito Way",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421659",
            "country_code": "US",
            "telephone_number": "208-202-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIM CHRISTOPHER KNUDSON DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHILD & ADOLESCENT PSYCHIATRIST",
        "authorized_official_telephone_number": "208-221-8088",
        "authorized_official_credential": "DO, MBA"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "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 Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.