Rachel M Koster, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-867 Issued in ID

Practice address

4650 Hawthorne Road,
Suite 3B
Chubbuck, ID 83202

Phone

(208) 237-9833

NPI assigned

Oct 19, 2010

Sex

Female

Sole proprietor

Yes

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rachel.koster.1@19704.direct.athenahealth.com

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.

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  Medicare reassignment NPD
• David P Ellent PLLC

  • Clinical Medical Laboratory
  • Kingwood, TX
  • NPI 1891348959
  NPD

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1437469830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 E MOSSY OAKS RD",
            "address_2": "STE 500",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773891813",
            "telephone_number": "208-237-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE ROAD,",
            "address_2": "SUITE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-237-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTER",
        "first_name": "RACHEL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Kam
• Brandi B Karroum, NP-C
• Renee Lynn Katter, PA-C
• Nora L Kirkpatrick, PA
• Douglas Aaron Klingler, LPC
• Barbara Krichbaum, L.P.C.
• Zayne B Lanier
• Lisa K Larsen, LMSW
• Jennifer Petty Layton, LSW
• Kurt D. Layton, LCSW

• Physician Assistant in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.