NPIMap

Individual provider Active NPI

Kendall Ann Gunderson, FNP

  • Family Nurse Practitioner
  • Coeur D Alene, ID
National Provider Identifier
1356992309
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
62732 Issued in ID
Practice address
700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone
(208) 625-6300
Fax
(208) 625-6301
NPI assigned
Sep 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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 62732 ID Primary

Addresses

Primary practice location

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Mailing address

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgunderson627560@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231001716 ID Practitioner - Nurse Practitioner 1850725748 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of North Idaho PAGroup PAC ID 4385635150, 32 clinicians

Practice addresses (Care Compare)

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6360

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Benewah Community Hospital CurrentSince Oct 14, 2020 Accepting new patients
Kootenai Health, Inc. CurrentSince Feb 16, 2020 Accepting new patients
Kootenai Health, Inc. CurrentSince Feb 16, 2020 Accepting new patients
Bonner General Hospital Inc. CurrentSince Mar 26, 2020 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Benewah Community Hospital Current Accepting new patients
Kootenai Health, Inc. Current Accepting new patients
Radiology Associates of North Idaho, PA CurrentSince Oct 14, 2019 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Bonner General Hospital, Inc CurrentSince Nov 1, 2020 Accepting new patients

Locations

700 W Ironwood Dr
Ste 175
Coeur D Alene, ID 83814
Phone (208) 625-6300

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

520 N Third Ave
Sandpoint, ID 83864
Phone (208) 263-0649

423 N Third Ave
Ste 210
Sandpoint, ID 83864
Phone (208) 263-1441

229 S 7th St
St Maries, ID 83861
Phone (208) 245-2591

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e8b4f872-6ea1-4b26-a974-041b5fb4c57b/

Organizations & group practices 11

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 2

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": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1356992309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6300",
            "fax_number": "208-625-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "KENDALL",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-21",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "62732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgunderson627560@direct.multicare.org",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr Ste 175",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.