Michelle Nicole Cano-Keighley, ARNP
Individual provider Active NPI Nurse Practitioner · Coeur D Alene, ID
NPI 1396089124 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1396089124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NP38380 (ID)
- Practice address
- 980 W Ironwood Dr Ste 1
Coeur D Alene, ID 83814 - Phone
- (208) 625-4333
- Fax
- (208) 625-4334
- NPI assigned
- Nov 16, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kootenai Health Inc
Practice addresses (Care Compare)
1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
980 W Ironwood Dr
Suite 306
Coeur D Alene, ID 83814-2668
Phone (208) 625-4970
Hospital & facility affiliations
- Kootenai Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130225000442 | ID | Practitioner - Nurse Practitioner | 9234384199 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP38380 | ID | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kootenai Health, Inc. | Current |
Accepting new patients | |
| Kootenai Health, Inc. | Current |
Accepting new patients | |
| Kootenai Health, Inc. | Nurse Practitioner | Current | Accepting new patients |
| Kootenai Health, Inc. | Current |
Accepting new patients | |
| Incyte Pathology, PLLC | Current | Accepting new patients | |
| Kootenai Health, Inc. | Current |
Accepting new patients |
Locations
980 W Ironwood Dr
Ste 1
Coeur D Alene, ID 83814
Phone (208) 625-4333
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085
323 N Spokane St
Unit 100
Post Falls, ID 83854
Phone (208) 777-1320
1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564
Interoperability endpoints
- mcanokeighley609655@direct.multicare.org
- michelle.canokeighley.p1@direct.spokaneallergy.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP38380 | ID | Yes |
Addresses
Primary practice location
980 W Ironwood Dr Ste 1
Coeur D Alene, ID 83814
Mailing address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-5085
Other practice location 1
508 W. 6th Ave
Suite 700
Spokane, WA 99204
Phone (509) 747-1624
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mcanokeighley609655@direct.multicare.org |
Other providers in Coeur D Alene, ID
- Canfield Family Medical Group LLC
- Canfield Physical Therapy
- Canfield PT PLLC
- Daniel Edward Cannon
- Danielle Elaine Cannon
- Canopy Village Inc.
- Jessica Capaul
- Danielle Lynn Capp
- Charles Hughes Cardarelli
- Deborah Christina Carder
All providers in Coeur D Alene, ID · Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.