Individual provider Active NPI

Kae Marie Hilliard-Dodge

  • Student in an Organized Health Care Education/Training Program
  • Moscow, ID
National Provider Identifier
1437842374
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
875 Perimeter Dr
Moscow, ID 83844-9803
Phone
(208) 855-6111
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Respiratory/Developmental/Rehabilitative Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 225500000X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

875 Perimeter Dr
Moscow, ID 83844-9803

Mailing address

239 Southview Ave # 4
Moscow, ID 83843-5081

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

NPI Registry JSON

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1437842374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 SOUTHVIEW AVE # 4",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 PERIMETER DR",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838449803",
            "telephone_number": "208-855-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIARD-DODGE",
        "first_name": "KAE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.