Kayla Brooking, DO
Individual provider Active NPI Family Medicine Physician · Caldwell, ID
NPI 1679365993 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1679365993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1071163 (ID)
- Practice address
- 315 E Elm St # 201
Caldwell, ID 83605-4857 - Phone
- (208) 514-2528
- Fax
- (208) 375-2217
- NPI assigned
- May 21, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250715002419 | ID | Order and Referring Only - Family Practice |
4880109214 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current |
Accepting new patients | |
| Full Circle Health, Inc. | Past |
Accepting new patients |
Locations
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
315 E Elm St
#201
Caldwell, ID 83605
Phone (208) 514-2528
Interoperability endpoints
- kbrooking703425@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1071163 | ID | Yes |
Addresses
Primary practice location
315 E Elm St # 201
Caldwell, ID 83605-4857
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Other providers in Caldwell, ID
- Alexandria Blake Briggs
- Jared Britton
- Anne Brock
- Jason Eric Bromley
- Derek Carl Bronson
- Diane Marie Brown
- Matthew S Brown
- Sherri L Brown
- Gavin Bruderer
- Angela Bruno
All providers in Caldwell, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.