Individual provider Active NPI

Michelle Nicole Cano-Keighley, ARNP

  • Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1396089124
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP38380 Issued in 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
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP38380 ID Primary

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 1

TypeEndpointUseAffiliation
Direct Messaging Address mcanokeighley609655@direct.multicare.org

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
I20130225000442 ID Practitioner - Nurse Practitioner 9234384199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP38380IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince May 1, 2019 Accepting new patients
Kootenai Health, Inc. Nurse Practitioner Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Incyte Pathology, LLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince May 1, 2019 Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

980 W Ironwood Dr
Ste 1
Coeur D Alene, ID 83814
Phone (208) 625-4333

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

323 N Spokane St
Unit 100
Post Falls, ID 83854
Phone (208) 777-1320

Interoperability endpoints

  • Direct secure messaging: mcanokeighley609655@direct.multicare.org
  • Direct secure messaging: michelle.canokeighley.p1@direct.spokaneallergy.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1396089124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5085",
            "fax_number": "208-625-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR STE 1",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-625-4333",
            "fax_number": "208-625-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 W. 6th Ave",
            "address_2": "Suite 700",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "99204",
            "country_code": "US",
            "telephone_number": "509-747-1624",
            "fax_number": "509-747-6774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANO-KEIGHLEY",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP38380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcanokeighley609655@direct.multicare.org",
            "affiliation": "N",
            "address_1": "980 W Ironwood Dr Ste 1",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.