NPIMap

Individual provider Active NPI

Katy Connley, FNP-C

  • Endocrinology, Diabetes & Metabolism Physician
  • Eagle, ID
National Provider Identifier
1679980551
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
NP-1451A Issued in ID
Practice address
951 E Plaza Dr Ste 110
Eagle, ID 83616-6567
Phone
(208) 274-9850
Fax
(208) 274-9581
NPI assigned
Jul 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NP-1451A ID Primary
Family Nurse Practitioner 363LF0000X NP-1451A ID

Addresses

Primary practice location

951 E Plaza Dr Ste 110
Eagle, ID 83616-6567

Mailing address

951 E Plaza Dr Ste 110
Eagle, ID 83616-6567
Phone (208) 274-9850

Other practice location 1

3250 W Cherry Lane
Meridian, ID 83642
Phone (208) 302-0600

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
I20140929002787 ID Practitioner - Nurse Practitioner 8921224619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

951 E Plaza Dr
Suite 110
Eagle, ID 83616-6567
Phone (208) 274-9580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1451AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Valley Metabolic Medicine Endocrinology, Diabetes & Metabolism CurrentSince Jul 25, 2019 Accepting new patients

Locations

951 E Plaza Dr
Ste 110
Eagle, ID 83616
Phone (208) 274-9580

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABDGCD/Endpoint/ABDGCD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1405123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1679980551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 E PLAZA DR STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166567",
            "telephone_number": "208-274-9850",
            "fax_number": "208-367-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 E PLAZA DR STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166567",
            "telephone_number": "208-274-9850",
            "fax_number": "208-274-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 W Cherry Lane",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83642",
            "country_code": "US",
            "telephone_number": "208-302-0600",
            "fax_number": "208-367-7316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNLEY",
        "first_name": "KATY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ID",
            "license": "NP-1451A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1451A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.