NPIMap

Individual provider Active NPI

Lynette N McCanna, NP-C

  • Family Nurse Practitioner
  • Sandpoint, ID
National Provider Identifier
1619107364
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78851 Issued in ID
Practice address
423 N 3Rd Ave Ste 210
Sandpoint, ID 83864-1511
Phone
(208) 265-2221
Fax
(208) 265-2229
NPI assigned
Jul 15, 2009
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60102358 WA
Family Nurse Practitioner 363LF0000X 78851 ID Primary

Addresses

Primary practice location

423 N 3Rd Ave Ste 210
Sandpoint, ID 83864-1511

Mailing address

423 N 3Rd Ave Ste 210
Sandpoint, ID 83864-1511
Phone (208) 265-2221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606001373 ID Practitioner - Nurse Practitioner 9436205556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonner General Hospital IncGroup PAC ID 4082690466, 47 clinicians

Practice addresses (Care Compare)

423 N 3Rd Ave
Sandpoint, ID 83864-1511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78851IDMDFamily Nurse Practitioner
AP60102358WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonner General Hospital Inc. CurrentSince May 1, 2024 Accepting new patients
Bonner General Hospital, Inc CurrentSince May 1, 2024 Accepting new patients
Bonner General Hospital, Inc. Past Accepting new patients
Bonner General Hospital, Inc. Past Accepting new patients

Locations

423 N Third Ave
Ste 210
Sandpoint, ID 83864
Phone (208) 263-1441

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.223001
  • Direct secure messaging: lynette.mccanna@bgh.gwaydirect.com

Organizations & group practices 4

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 7

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1619107364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N 3RD AVE STE 210",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641511",
            "telephone_number": "208-265-2221",
            "fax_number": "208-265-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N 3RD AVE STE 210",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641511",
            "telephone_number": "208-265-2221",
            "fax_number": "208-265-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANNA",
        "first_name": "LYNETTE",
        "middle_name": "N",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60102358",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "78851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

Verify at the official NPI Registry.