Individual provider Active NPI

Kayla Rae Kendall, FNP

  • Family Nurse Practitioner
  • Hayden, ID
National Provider Identifier
1528805595
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024010582 Issued in ID
Practice address
8880 N Hess St
Hayden, ID 83835-8716
Phone
(208) 295-5772
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 2024010582 ID Primary

Addresses

Primary practice location

8880 N Hess St
Hayden, ID 83835-8716

Mailing address

9100 N Baldwin CT
Hayden, ID 83835-9887
Phone (413) 636-3498

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118003763 ID Order and Referring Only - Nurse Practitioner 9638604341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024010582IDMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1528805595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 N BALDWIN CT",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359887",
            "telephone_number": "413-636-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 N HESS ST",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358716",
            "telephone_number": "208-295-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "KAYLA",
        "middle_name": "RAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "2024010582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.