Individual provider Active NPI

Kenneth Nye Weybright II, RN

  • Registered Nurse
  • Boise, ID
National Provider Identifier
1437609625
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
54067 Issued in ID
Practice address
6687 W Winston LN Apt 102
Boise, ID 83704-5120
Phone
(208) 571-0463
NPI assigned
Oct 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 54067 ID Primary

Addresses

Primary practice location

6687 W Winston LN Apt 102
Boise, ID 83704-5120

Mailing address

6687 W Winston LN Apt 102
Boise, ID 83704-5120
Phone (208) 571-0463

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
54067IDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1437609625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6687 W WINSTON LN APT 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045120",
            "telephone_number": "208-571-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6687 W WINSTON LN APT 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045120",
            "telephone_number": "208-571-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYBRIGHT",
        "first_name": "KENNETH",
        "middle_name": "NYE",
        "name_suffix": "II",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "54067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.