Individual provider Active NPI

Carolyn Rees, M.D.

  • Internal Medicine Physician
  • Caldwell, ID
National Provider Identifier
1386683431
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M7111 Issued in ID
Practice address
211 E Logan St
Suite 303
Caldwell, ID 83605-0000
Phone
(208) 459-4667
Fax
(208) 459-3372
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M7111 ID Primary

Addresses

Primary practice location

211 E Logan St
Suite 303
Caldwell, ID 83605-0000

Mailing address

PO Box 277976
Atlanta, GA 30384-7976
Phone (208) 459-4667

Other identifiers 2

IdentifierTypeStateIssuer
000010002266OtherIDBLUE SHIELD
804151800MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M7111IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Medical Group LLC Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
West Valley Professional Fee Billing, LLC Internal Medicine Past Accepting new patients
West Valley Medical Group Specialty Services LLC Past Accepting new patients

Locations

211 E Logan St
Ste 303
Caldwell, ID 83605
Phone (208) 250-2834

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

745 S Progress Ave
Ste 120
Meridian, ID 83642
Phone (208) 795-5073

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1386683431",
    "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",
            "telephone_number": "208-459-4667",
            "fax_number": "208-459-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E LOGAN ST",
            "address_2": "SUITE 303",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836050000",
            "telephone_number": "208-459-4667",
            "fax_number": "208-459-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REES",
        "first_name": "CAROLYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M7111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010002266",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804151800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.