Individual provider Active NPI

Kurtis Rex Holt, M.D.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1568419182
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-9589 Issued in ID
Practice address
701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone
(208) 381-6500
NPI assigned
May 28, 2006
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD23658 OR
Emergency Medicine Physician 207P00000X M-9589 ID Primary

Addresses

Primary practice location

701 E Parkcenter Blvd
Boise, ID 83706-6528

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

335 SE 8th Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Other identifiers 1

IdentifierTypeStateIssuer
286825MedicaidOR

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
I20060721000205 ID Practitioner - Emergency Medicine 8729074430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone (208) 381-6500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-9589IDMDEmergency Medicine Physician
MD23658ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Emergency Medicine CurrentSince Nov 4, 2022 Accepting new patients
Idaho Em I Medical Services PC Emergency Medicine Past Accepting new patients
Tacoma Emergency Medicine Associates PC Emergency Medicine Past Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Olympia Emergency Services, PLLC Emergency Medicine PastSince May 12, 2024 Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

Interoperability endpoints

  • Direct secure messaging: hkurtis259172@ahs.direct-ci.com
  • Direct secure messaging: kholt633995@direct.ochin.org

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 4

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1568419182",
    "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": "701 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066528",
            "telephone_number": "208-381-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 SE 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234246",
            "country_code": "US",
            "telephone_number": "503-681-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KURTIS",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD23658",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-9589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286825",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.