In Balance: Integrative Primary Healthcare PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP1287A Issued in ID

Legal business name

IN BALANCE: INTEGRATIVE PRIMARY HEALTHCARE PLLC

Practice address

1017 E Young St
Pocatello, ID 83201-5237

Phone

(208) 425-6444

Fax

(208) 425-6477

NPI assigned

Jul 30, 2018

Last updated

Apr 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathryn Jill Roth, MSN, APRN, FNP-CNPI 1467893289

Title

Owner

Phone

(208) 242-3723

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Jill Roth, FNP-C

  • Family Nurse Practitioner
  • Pocatello, ID
  • NPI 1467893289
  Authorized official Same address or phone

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1457839730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 E YOUNG ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015237",
            "telephone_number": "208-425-6444",
            "fax_number": "208-425-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E YOUNG ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015237",
            "telephone_number": "208-425-6444",
            "fax_number": "208-425-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN BALANCE: INTEGRATIVE PRIMARY HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-242-3723",
        "authorized_official_credential": "MSN, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP1287A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.