Matthew Kam

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LPC5260 Issued in ID

Practice address

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Phone

(208) 252-5621

Fax

(208) 648-4167

NPI assigned

Jun 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Matthew Kam Other name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canvi Behavioral Health PLLCGroup PAC ID 0941692073, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Canvi Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
  • NPI 1144984873
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1457646895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Iris Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803042226",
            "country_code": "US",
            "telephone_number": "303-443-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAM",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LPC5260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "KAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Randall Jones Jr., MD
• William Jordan, PHARMD
• Grace Elaine Jory, PT, DPT
• Joseph Leon Martindale
• Joseph Martindale, DO,PA
• Brandi B Karroum, NP-C
• Renee Lynn Katter, PA-C
• Nora L Kirkpatrick, PA
• Douglas Aaron Klingler, LPC
• Rachel M Koster, PA-C

• Marriage & Family Therapist in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.