Carisa Dawn Elliott, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12180577 Issued in ID

Practice address

370 North Haven Drive
Twin Falls, ID 83301-6178

Phone

(208) 733-1112

NPI assigned

Aug 28, 2019

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGCCCA/Endpoint/DGCCCA

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.

• Camille Smith DO PA

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1407246929
  Medicare reassignment NPD
• Kenneth C Romney MD Inc

  dba The Family Clinic

  • Medical Specialty Clinic/Center
  • Twin Falls, ID
  • NPI 1982015822
  NPD (past)
• Kimi Recovery Center LLC

  • Community/Behavioral Health Agency
  • Twin Falls, ID
  • NPI 1396254066
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1518515949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RAINBOW CIR",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833161241",
            "telephone_number": "208-316-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 NORTH HAVEN DRIVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016178",
            "telephone_number": "208-733-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CARISA",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "F12180577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Elam, BS
• Josie Elam
• Rachel Ann Eldredge, ATC
• Elite Medicine PC (Genesis Restorative Medicine)
• Inga L Elkin, M.ED, LCPC
• Julie A Ellis, PT
• Mark Dalton Ellis, LMSW
• Corwin Ryan Ellsworth, PA-C
• Brandy Gail Emdin
• Valerie Jeannine Emery, BEHAVIORAL TECH

• Family Nurse Practitioner in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.