Individual provider Active NPI

Carly H Loebel, MD

  • Family Medicine Physician
  • Eagle, ID
National Provider Identifier
1538855648
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9271554 Issued in ID
Practice address
3101 E State St Ste 1100
Eagle, ID 83616-6232
Phone
(208) 473-3500
Fax
(208) 473-3510
NPI assigned
Apr 12, 2023
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9271554 ID Primary

Addresses

Primary practice location

3101 E State St Ste 1100
Eagle, ID 83616-6232

Mailing address

190 E Bannock St
Boise, ID 83712-6241

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604001235 ID Practitioner - Family Practice 9133573918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1919 Lincoln Way
Suite 315
Coeur D Alene, ID 83814-2527
Phone (208) 625-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince Apr 22, 2025 Accepting new patients
Kootenai Health, Inc. CurrentSince Apr 22, 2025 Accepting new patients

Locations

1919 Lincoln Way
Ste 315
Coeur D Alene, ID 83814
Phone (208) 625-6000

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1538855648",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 E STATE ST STE 1100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166232",
            "telephone_number": "208-473-3500",
            "fax_number": "208-473-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEBEL",
        "first_name": "CARLY",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "9271554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.