Individual provider Active NPI

Kylee Dee Johnson, APRN, CNM, WHNP

  • Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1538636121
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2371485 Issued in ID
Practice address
2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042
Phone
(208) 201-8265
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 59832 ID
Nurse Practitioner 363L00000X 2371485 ID Primary

Addresses

Primary practice location

2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042

Mailing address

2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042
Phone (208) 497-0541

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190326000210 ID Practitioner - Certified Nurse Midwife (CNM) 1456691609 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
2371485IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Womens Healthcare Corp,P.C. CurrentSince Dec 4, 2018 Accepting new patients
Rocky Mountain Wellness Clinic Current Accepting new patients
Rocky Mountain Womens Clinic LLC Midwife CurrentSince Sep 1, 2020 Accepting new patients

Locations

1550 Elk Creek Dr
Idaho Falls, ID 83404
Phone (208) 524-6308

2065 E 17th St
Ste A
Idaho Falls, ID 83404
Phone (208) 522-3301

Interoperability endpoints

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1538636121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "208-497-0541",
            "fax_number": "208-497-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "208-201-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLEE",
        "middle_name": "DEE",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "ID",
            "license": "59832",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "2371485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.