Kurt E Kracaw MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-13115 Issued in ID

Legal business name

KURT E KRACAW MD LLC

Practice address

426 Farnsworth Way Ste 1
Rigby, ID 83442-4713

Phone

(208) 745-9411

Fax

(208) 745-9910

NPI assigned

Oct 17, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kurt Edwin Kracaw, MD

Title

Owner

Phone

(775) 772-4208

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brigham Derk Murray, CRNA

  • Certified Registered Nurse Anesthetist
  • Nampa, ID
  • NPI 1619234655
  NPD (past)

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1467963496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3208",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834033208",
            "telephone_number": "208-523-4906",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 FARNSWORTH WAY STE 1",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834424713",
            "telephone_number": "208-745-9411",
            "fax_number": "208-745-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KURT E KRACAW MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "KRACAW",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-772-4208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-13115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1285723460",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Lee Jephson, D.C.
• Jenny L Johnson, MS, CCC-SLP
• James Jones
• Chad Judy
• Nikole Kirby, AGACNP-BC
• Christie Larae Lamb, LCSW
• James G Lamb, AU.D.
• Fallyn Ray Lambertsen, PHARMD
• Kelsey Bryn Larson, M.S., CCC-SLP
• Kathy Lebaron, L.M., C.P.M

• Family Medicine Physician in Rigby, ID
• Providers in Rigby, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.