Katrina Larene Mace

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

78422 Issued in ID

Practice address

1047 S Wells St
Meridian, ID 83642-7997

Phone

(208) 297-3428

Fax

(208) 297-3978

NPI assigned

Jan 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Haas Associates, LLCGroup PAC ID 4880080100, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Haas Associates, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
  • NPI 1497406904

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1477323947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 MAPLEWOOD ST",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833185511",
            "telephone_number": "208-431-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 S WELLS ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427997",
            "telephone_number": "208-297-3428",
            "fax_number": "208-297-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACE",
        "first_name": "KATRINA",
        "middle_name": "LARENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "78422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Geddes Lyons, PT, DPT
• Robert A Lyons, MD
• Jennifer Lytle, FNP-C
• Paul Tyler Lytle, DMD
• Vanessa Macdonagh, CSFA
• Rebecca Mace
• Julie Macgregor, PA-C, LE
• Mack B. Stephenson, PH.D., CHTD
• Mark Macumber, MD
• Kathryn Maddux, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.