Kenneth James Gunderson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12230320 Issued in ID

Practice address

1950 Saint Clair Rd
Idaho Falls, ID 83404-6306

Phone

(208) 569-8249

NPI assigned

Dec 14, 2023

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• St Johns Medical Center Hospital, Jackson, WY, CCN 530015
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Utah Regional Hospitalists LLC

  dba Utah Regional Hospitalists

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1659149086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SAINT CLAIR RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046306",
            "telephone_number": "208-569-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SAINT CLAIR RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046306",
            "telephone_number": "208-569-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "F12230320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Alen Grube, DPT, PT
• Eliseo Guerra
• Solange Guerrero Rodriguez, BA
• Magali Guerrero
• Jason Bill Gundersen, MD
• Jamie Kae Gunerud, OTR/L
• Jennifer Anne Gunter, PHARMD
• Ritika Gupta
• Antonia Gutierrez Benitez, LPC
• Neal Boyd Guymon, O.D.

• Family Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.