Active NPI
Kelsey Field Babcock, PA
- Physician Assistant
- Boise, ID
National Provider Identifier
1528316700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1063
- Practice address
- 500 W Fort St # 111
Boise, ID 83702-4599 - Phone
- (208) 422-1000
- Fax
- (208) 422-1319
- NPI assigned
- Aug 20, 2012
- Last updated
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1063 | ID | Primary |
Addresses
Primary practice location
500 W Fort St # 111
Boise, ID 83702-4599
Mailing address
500 W Fort St # 111
Boise, ID 83702-4599
Phone (208) 422-1000
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210709000630 | ID | Order and Referring Only - Physician Assistant | 0749434769 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-1063 | ID | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1528316700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W FORT ST # 111",
"city": "BOISE",
"state": "ID",
"postal_code": "837024599",
"telephone_number": "208-422-1000",
"fax_number": "208-422-1319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W FORT ST # 111",
"city": "BOISE",
"state": "ID",
"postal_code": "837024599",
"telephone_number": "208-422-1000",
"fax_number": "208-422-1319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BABCOCK",
"first_name": "KELSEY",
"middle_name": "FIELD",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-20",
"last_updated": "2022-02-17",
"certification_date": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
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- Chase N Ayres, PHARMD
- Azure River Wellness, Counseling LLC
- B & B Lingerie Company, Inc. (Bosom Buddy Breast Forms)
- Christy Babcock, LPC
- Lisa Babiak, PHARMD
- Babichenko Dental Lab (European Denture Center)
- Gennady S Babichenko, LD
- Amy L Bacca, APRN AGCNS-BC
- Gail M Baccheschi, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.