NPIMap

Individual provider Active NPI

Katherine Brooke Hall, P.A.

  • Physician Assistant
  • Post Falls, ID
National Provider Identifier
1366497547
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1846 Issued in ID
Practice address
1125 E Polston Ave Ste B
Post Falls, ID 83854-6045
Phone
(208) 758-0075
Fax
(208) 758-0076
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10005306 WA
Medical Physician Assistant 363AM0700X 0110002075 VA
Physician Assistant 363A00000X PA1846 ID Primary

Addresses

Primary practice location

1125 E Polston Ave Ste B
Post Falls, ID 83854-6045

Mailing address

70 Medical Center Cir
Suite 301
Fishersville, VA 22939-2273
Phone (540) 448-8819

Other identifiers 1

IdentifierTypeStateIssuer
010235421MedicaidVA

Other names 1

  • Miss Katherine Brooke Harper Former name

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
I20200824000838 ID Practitioner - Physician Assistant 2365477528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Selkirk Endocrinology, PLLCGroup PAC ID 5294097176, 3 clinicians

Practice addresses (Care Compare)

1125 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 758-0075

1125 E Polston Ave B
Post Falls, ID 83854-6045

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
  • Newport Community Hospital Hospital, Newport, WA, CCN 501310
  • Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1846IDMDPhysician Assistant
PA10005306WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Hugo RDN LD CurrentSince Aug 1, 2021 Accepting new patients

Locations

1125 E Polston Ave
#B
Post Falls, ID 83854
Phone (208) 640-4502

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.

Hospital & facility affiliations 7

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1366497547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR",
            "address_2": "SUITE 301",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-448-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E POLSTON AVE STE B",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-758-0075",
            "fax_number": "208-758-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KATHERINE",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005306",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002075",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010235421",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HARPER",
            "middle_name": "BROOKE",
            "prefix": "MISS",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.