NPIMap

Individual provider Active NPI

Jennifer King, FNP-BC

  • Family Nurse Practitioner
  • Ontario, OR
National Provider Identifier
1477958494
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201407668NP-PP Issued in OR
Practice address
1219 SW 4TH Ave
Unit 1
Ontario, OR 97914-4566
Phone
(541) 889-2668
NPI assigned
Nov 3, 2014
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X N-1512A ID
Family Nurse Practitioner 363LF0000X 201407668NP-PP OR Primary
Nurse Practitioner 363L00000X AP61055386 WA

Addresses

Primary practice location

1219 SW 4TH Ave
Unit 1
Ontario, OR 97914-4566

Mailing address

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3244

Other practice location 1

817 S Perry St Unit B
Spokane, WA 99202-3443
Phone (509) 444-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181115000564 ID Practitioner - Nurse Practitioner 2668798588 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walter Knox Memorial HospitalGroup PAC ID 7012907785, 21 clinicians

Practice addresses (Care Compare)

1102 E Locust St
Emmett, ID 83617-2713
Phone (208) 365-6004

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61055386WAMDNurse Practitioner
N-1512AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Knox Memorial Hospital CurrentSince Apr 1, 2020 Accepting new patients
Core Medicine Idaho, LLC CurrentSince Jun 6, 2024 Accepting new patients
Rxpad Medical Family CurrentSince Mar 12, 2024 Accepting new patients
Walter Knox Memorial Hospital CurrentSince Apr 1, 2020 Accepting new patients
Southern Idaho Health Partners LLC CurrentSince Nov 1, 2021 Accepting new patients
Np2U, LLC Nurse Practitioner CurrentSince Apr 1, 2020 Accepting new patients
Walter Knox Memorial Hospital Past Accepting new patients
Prescription Pad LLC PastSince Jan 26, 2020 Accepting new patients

Locations

4605 Enterprise Way
Ste 101
Caldwell, ID 83605
Phone (208) 353-7518

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

2135 S Sub Station Rd
Emmett, ID 83617
Phone (208) 488-6300

1102 E Locust St
Emmett, ID 83617
Phone (208) 365-6004

1620 N Whitley Dr
Ste 103
Fruitland, ID 83619
Phone (208) 452-7075

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

9850 W St Lukes Dr
Ste 129
Nampa, ID 83687
Phone (208) 205-7600

1000 S 16th St
Ste C
Payette, ID 83661
Phone (208) 637-2273

7632 SW Durham Rd
Ste 105
Tigard, OR 97224
Phone (844) 744-2200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1477958494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3244",
            "fax_number": "208-463-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 SW 4TH AVE",
            "address_2": "UNIT 1",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144566",
            "telephone_number": "541-889-2668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 S Perry St Unit B",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992023443",
            "country_code": "US",
            "telephone_number": "509-444-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "N-1512A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201407668NP-PP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61055386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.