Individual provider Active NPI

Caroline C Keeney, NP-C

  • Family Nurse Practitioner
  • Ketchum, ID
National Provider Identifier
1528356276
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4271787 Issued in ID
Practice address
100 Hospital Dr
Ketchum, ID 83340
Phone
(208) 727-8710
Fax
(208) 727-8685
NPI assigned
Jul 15, 2011
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4271787 ID Primary
Family Nurse Practitioner 363LF0000X 4759616-4405 UT

Addresses

Primary practice location

100 Hospital Dr
Ketchum, ID 83340

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866

Other practice location 1

30 N 1900 E
Room 4A100
Salt Lake City, UT 84132-0100
Phone (801) 585-2341

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckeeney6359@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120110000631 UT Practitioner - Nurse Practitioner 9234305491 Reassigns benefits to 1 organization
I20260603002951 ID Practitioner - Nurse Practitioner 9234305491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Ketchum, ID 83340

100 Hospital Dr
Ketchum, ID 83340-9998

191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4271787IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
Fasttrack Immediate Care of Eastman LLC PastSince Oct 14, 2014 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 6

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 3

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1528356276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-727-8710",
            "fax_number": "208-727-8685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E",
            "address_2": "Room 4A100",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320100",
            "country_code": "US",
            "telephone_number": "801-585-2341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENEY",
        "first_name": "CAROLINE",
        "middle_name": "C",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "4271787",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "4759616-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckeeney6359@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ketchum, ID

Sources for this page

Verify at the official NPI Registry.