Individual provider Active NPI

Kristy L Unruh, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • Arco, ID
National Provider Identifier
1629627575
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
62605 Issued in ID
Practice address
551 Highland Dr
Arco, ID 83213-5003
Phone
(208) 252-7654
NPI assigned
Sep 4, 2019
Last updated
Sep 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 62605 ID Primary

Addresses

Primary practice location

551 Highland Dr
Arco, ID 83213-5003

Mailing address

PO Box 145
Arco, ID 83213-0145
Phone (208) 252-7654

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
I20200804001466 ID Practitioner - Nurse Practitioner 8820413131 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lost Rivers Medical CenterGroup PAC ID 7810807427, 16 clinicians

Practice addresses (Care Compare)

313 Hwy 93
Mackay Clinic
Mackay, ID 83251-1111
Phone (208) 588-2993

551 Highland Dr
Arco, ID 83213-5003
Phone (208) 252-7654

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62605IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lost Rivers Medical Center Family Medicine CurrentSince Feb 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristy.unruh.1@11894.direct.athenahealth.com

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 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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1629627575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "ARCO",
            "state": "ID",
            "postal_code": "832130145",
            "telephone_number": "208-252-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 HIGHLAND DR",
            "city": "ARCO",
            "state": "ID",
            "postal_code": "832135003",
            "telephone_number": "208-252-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNRUH",
        "first_name": "KRISTY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "62605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arco, ID

Sources for this page

Verify at the official NPI Registry.