Active NPI
Keisch Ann Exner, LMP
- Specialist
- Hayden, ID
National Provider Identifier
1467513028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 512452-06
- Practice address
- 8475 N Government Way
Suite 103
Hayden, ID 83835-8670 - Phone
- (208) 762-6772
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 512452-06 | WA | Primary |
Addresses
Primary practice location
8475 N Government Way
Suite 103
Hayden, ID 83835-8670
Mailing address
PO Box 36
Careywood, ID 83809-0036
Phone (425) 870-7777
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 512452-06 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wildflower Spa at Seasons | Current | Accepting new patients |
Organizations & group practices 1
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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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467513028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 36",
"city": "CAREYWOOD",
"state": "ID",
"postal_code": "838090036",
"telephone_number": "425-870-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8475 N GOVERNMENT WAY",
"address_2": "SUITE 103",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358670",
"telephone_number": "208-762-6772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXNER",
"first_name": "KEISCH",
"middle_name": "ANN",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "512452-06",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.