Individual provider Active NPI

Kurt Earl Kinghorn, DPM

  • Foot & Ankle Surgery Podiatrist
  • Meridian, ID
National Provider Identifier
1396023446
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P-230 Issued in ID
Practice address
1540 W Cayuse Creek Dr
Meridian, ID 83646-4795
Phone
(208) 344-3324
Fax
(208) 344-4349
NPI assigned
Jul 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P-230 ID Primary

Addresses

Primary practice location

1540 W Cayuse Creek Dr
Meridian, ID 83646-4795

Mailing address

1540 W Cayuse Creek Dr
Meridian, ID 83646-4795
Phone (208) 344-3324

Other identifiers 1

IdentifierTypeStateIssuer
1396023446MedicaidID

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140708002015 ID Practitioner - Podiatry 1254556186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1540 W Cayuse Creek Dr
Meridian, ID 83646-4795
Phone (208) 344-3324

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions25
Removal of nail tissue31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P-230IDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luke a. Randall PLLC CurrentSince Jul 1, 2014 Accepting new patients
Ankle & Foot Medical Center PC Foot & Ankle Surgery CurrentSince Apr 22, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Jeffrey L. Chandler, DPM Past Accepting new patients

Locations

222 N 2nd St
Ste 301
Boise, ID 83702
Phone (208) 344-3324

1540 W Cayuse Creek Dr
Meridian, ID 83646
Phone (208) 258-6200

Organizations & group practices 4

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": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1396023446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 W CAYUSE CREEK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464795",
            "telephone_number": "208-344-3324",
            "fax_number": "208-344-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 W CAYUSE CREEK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464795",
            "telephone_number": "208-344-3324",
            "fax_number": "208-344-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGHORN",
        "first_name": "KURT",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P-230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396023446",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.