Colt Kennington

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

O-1812 Issued in ID

Practice address

1906 Fairview Ave Ste 220
Caldwell, ID 83605-5432

Phone

(208) 795-5072

NPI assigned

Apr 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Arizona College of Osteopathic Medicine Mid Western University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

West Valley Medical Group LLCGroup PAC ID 8729180310, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Valley Medical Center Hospital, Caldwell, ID, CCN 130014
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• West Valley Medical Group LLC

  • Internal Medicine Physician
  • Caldwell, ID
  • NPI 1871673798
  Medicare reassignment Care Compare group NPD
• Uhs of Denver, Inc.

  • Psychiatric Hospital
  • Littleton, CO
  • NPI 1326133216
  NPD
• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  NPD (past)
• Eastern Idaho Health Services Inc

  • Psychiatric Hospital Unit
  • Idaho Falls, ID
  • NPI 1740287911
  NPD (past)
• West Valley Medical Center, Inc.

  • General Acute Care Hospital
  • Caldwell, ID
  • NPI 1891732905
  NPD (past)
• West Valley Medical Group Specialty Services LLC

  • Obesity Medicine (Obstetrics & Gynecology) Physician
  • Caldwell, ID
  • NPI 1245659093
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• West Valley Medical Center Inc

  • General Acute Care Hospital
  • Middleton, ID
  • NPI 1609818483
  Care Compare affiliation
• West Valley Medical Center, Inc.

  • General Acute Care Hospital
  • Caldwell, ID
  • NPI 1891732905
  Care Compare affiliation

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1386106268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277976",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 220",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055432",
            "telephone_number": "208-795-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNINGTON",
        "first_name": "COLT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "O-1812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ke Therapy PLLC
• Christopher Ryan Keller, MD
• Melody Keller, ND
• Merle L. Keller III, MD
• Tatiana Marie Kennedy
• Randon Kessinger
• Keven Freeman DMD PLLC
• Kevin Cotter Odpa
• Mark Keylor, LMSW
• Leila Khaddour, MD

• Psychiatry Physician in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.