Active NPI
Teresa York, RN
- In Home Supportive Care Agency
- Kamiah, ID
National Provider Identifier
1629428362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- W143727
- Practice address
- 169 Beaverslide Rd
Kamiah, ID 83536-5113 - Phone
- (208) 935-7963
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | W143727 | ID | Primary |
Addresses
Primary practice location
169 Beaverslide Rd
Kamiah, ID 83536-5113
Mailing address
169 Beaverslide Rd
Kamiah, ID 83536
Phone (208) 935-7963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0002751 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W143727 | ID | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1629428362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 BEAVERSLIDE RD",
"city": "KAMIAH",
"state": "ID",
"postal_code": "83536",
"telephone_number": "208-935-7963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 BEAVERSLIDE RD",
"city": "KAMIAH",
"state": "ID",
"postal_code": "835365113",
"telephone_number": "208-935-7963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORK",
"first_name": "TERESA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "ID",
"license": "W143727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A0002751",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kamiah, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.