Individual provider Active NPI

Camille L. Volking, NP

  • Nurse Practitioner
  • Hayden, ID
National Provider Identifier
1578862017
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22803 Issued in ID
Practice address
1986 W Hayden Ave Ste C
Hayden, ID 83835-7412
Phone
(208) 762-7760
Fax
(208) 762-7740
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22803 ID Primary

Addresses

Primary practice location

1986 W Hayden Ave Ste C
Hayden, ID 83835-7412

Mailing address

1986 W Hayden Ave Ste C
Hayden, ID 83835-7412
Phone (208) 762-7760

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
I20110804000620 ID Practitioner - Nurse Practitioner 3375712516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22803IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Nephrology Associates, Inc. CurrentSince Jan 1, 2012 Accepting new patients

Locations

1986 W Hayden Ave
Hayden, ID 83835
Phone (208) 666-0909

8836 N Hess St
Ste C
Hayden, ID 83835
Phone (208) 762-0909

1986 W Hayden Ave
Ste C
Hayden, ID 83835
Phone (208) 762-7760

Interoperability endpoints

  • Direct secure messaging: cvolking438902@direct.multicare.org

Organizations & group practices 1

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1578862017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1986 W HAYDEN AVE STE C",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 W HAYDEN AVE STE C",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLKING",
        "first_name": "CAMILLE",
        "middle_name": "L.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "22803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.