Kathryn Ann Werner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1284 Issued in ID

Practice address

3527 S Federal Way
Suite 103-424
Boise, ID 83705-5204

Phone

(208) 391-7280

Fax

(534) 202-4595

NPI assigned

Nov 6, 2007

Last updated

Dec 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Kathryn Ann Harris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kathryn Werner, PA-C LLC

  dba White Pine Mental Health & Wellness

  • Adult Mental Health Clinic/Center
  • Prattville, AL
  • NPI 1265068324
  NPD Authorized official
• Kathryn Werner, PA-C LLC

  dba White Pine Mental Health & Wellness

  • Physician Assistant
  • Prattville, AL
  • NPI 1376162263
  NPD Authorized official

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1336329523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 WYNFIELD DR.",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360677157",
            "telephone_number": "208-391-7280",
            "fax_number": "534-202-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 S FEDERAL WAY",
            "address_2": "SUITE 103-424",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055204",
            "telephone_number": "208-391-7280",
            "fax_number": "534-202-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA1373",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1284",
            "primary": true
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "ID",
            "license": "PA1284",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "AL",
            "license": "PA1373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO BOARD OF MEDICINE",
            "identifier": "PA-1284",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF MEDICAL EXAMINERS",
            "identifier": "PA.1373",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "HARRIS",
            "middle_name": "ANN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tom Wenzel
• Weport Medical Pharmacy
• William Guy Weppner, M.D.
• John M Werdel, MD
• Avonlea Werdell
• Amy Marie Wernsing, LPC
• Mark R Weron
• Jennifer Lee Wersland, PSYD
• Kelsey Janel Wertzler, MD
• Camden Wesselman

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.