Individual provider Active NPI

Katherine Lynn Kaiser Devlin, ARNP

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1366620825
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1396A Issued in ID
Practice address
1880 W Judith Lane
Boise, ID 83705
Phone
(208) 302-5200
Fax
(208) 302-5225
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30007931 WA
Family Nurse Practitioner 363LF0000X NP-1396A ID Primary

Addresses

Primary practice location

1880 W Judith Lane
Boise, ID 83705

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 302-5200

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
I20140521002387 ID Practitioner - Nurse Practitioner 3274617618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

6533 W Emerald St
Boise, ID 83704-8737
Phone (208) 302-5200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-1396AIDMDFamily Nurse Practitioner
AP30007931WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 21, 2014 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 21, 2014 Accepting new patients

Locations

1880 W Judith Ln
Boise, ID 83705
Phone (208) 302-5200

6533 W Emerald St
Boise, ID 83704
Phone (208) 302-5200

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: kdevlin1564236@direct.trinity-health.org

Organizations & group practices 3

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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1366620825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-5200",
            "fax_number": "208-302-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W JUDITH LANE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83705",
            "telephone_number": "208-302-5200",
            "fax_number": "208-302-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "KATHERINE",
        "middle_name": "LYNN KAISER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007931",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1396A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.