Kinghorn Health and Wellness Inc

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

KINGHORN HEALTH AND WELLNESS INC

Practice address

2001 S Woodruff Ave Ste 20
Idaho Falls, ID 83404-6373

Phone

(208) 970-2355

NPI assigned

Nov 18, 2020

Last updated

Mar 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew S Kinghorn, APRN, FNP-C

Title

President

Phone

(208) 520-9336

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1639772049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 20",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046373",
            "telephone_number": "208-970-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 20",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046373",
            "telephone_number": "208-970-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGHORN HEALTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "KINGHORN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-520-9336",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "APRN-62114",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Albert King, MS, OTR/L
• Kenneth William King Jr., O.D.
• Kimberly King, FNTP
• Patrick Ross King, PMHNP
• Tristan King
• Elizabeth Kinghorn
• Matthew Scott Kinghorn, FNP-C
• Julia Evalyne Kippen, LMSW
• Claudia Roberts Kirchgasler, MA CCC SLP
• Thomas Michael Kirschen, DO

• Primary Care Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.