NPIMap

Individual provider Active NPI

Kristine P Kingery, PA-C

  • Physician Assistant
  • Middleton, ID
National Provider Identifier
1679517155
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA582 Issued in ID
Practice address
381 S Middleton Rd Ste B
Middleton, ID 83644-5369
Phone
(208) 585-6311
NPI assigned
Jun 15, 2006
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA582 ID Primary

Addresses

Primary practice location

381 S Middleton Rd Ste B
Middleton, ID 83644-5369

Mailing address

PO Box 277976
Atlanta, GA 30384-7976

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristine.kinger@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121000892 ID Practitioner - Physician Assistant 2668491465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA582IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Medical Group Specialty Services LLC Past Accepting new patients
Reed I. Ward, D.O., P.a. Family Medicine PastSince Jul 1, 2002 Accepting new patients
Mountain View Hospital LLC Past Accepting new patients
Hti Physician Services of Utah, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristine.kinger@hca3.eclinicaldirectplus.com
  • Direct secure messaging: kristine.kingery@hca3.eclinicaldirectplus.com

Organizations & group practices 6

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1679517155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277976",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 S MIDDLETON RD STE B",
            "city": "MIDDLETON",
            "state": "ID",
            "postal_code": "836445369",
            "telephone_number": "208-585-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGERY",
        "first_name": "KRISTINE",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristine.kinger@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "381 S Middleton Rd",
            "city": "Middleton",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836445369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middleton, ID

Sources for this page

Verify at the official NPI Registry.