Individual provider Active NPI

Kenneth Ray Lowther, FNP-C

  • Family Nurse Practitioner
  • Pocatello, ID
National Provider Identifier
1508148677
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1104A Issued in ID
Practice address
965 Berryman Rd
Unit a
Pocatello, ID 83201-5572
Phone
(208) 221-6121
Fax
(888) 798-7346
NPI assigned
Sep 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-1104A ID Primary

Addresses

Primary practice location

965 Berryman Rd
Unit a
Pocatello, ID 83201-5572

Mailing address

965 Berryman Rd
Unit a
Pocatello, ID 83201-5572
Phone (208) 221-6121

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1104AIDMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1508148677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 BERRYMAN RD",
            "address_2": "UNIT A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015572",
            "telephone_number": "208-221-6121",
            "fax_number": "888-798-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BERRYMAN RD",
            "address_2": "UNIT A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015572",
            "telephone_number": "208-221-6121",
            "fax_number": "888-798-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWTHER",
        "first_name": "KENNETH",
        "middle_name": "RAY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.