Individual provider Active NPI

Jessica Aubry Greensides, NP

  • Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1689469991
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8371858 Issued in ID
Practice address
1919 Lincoln Way Ste 110
Coeur D Alene, ID 83814-2527
Phone
(208) 625-4515
NPI assigned
Apr 9, 2025
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8371858 ID Primary

Addresses

Primary practice location

1919 Lincoln Way Ste 110
Coeur D Alene, ID 83814-2527

Mailing address

5460 W Highland Dr
Coeur D Alene, ID 83814-9740
Phone (208) 691-2566

Other practice location 1

1300 E Mullan Ave Ste 1600
Post Falls, ID 83854-6054
Phone (208) 625-4965

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250521003709 ID Practitioner - Nurse Practitioner 1759800865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1919 Lincoln Way
Suite 110
Coeur D Alene, ID 83814-2527
Phone (208) 625-4515

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince May 1, 2025 Accepting new patients
Kootenai Health, Inc. CurrentSince May 1, 2025 Accepting new patients
Kootenai Health, Inc. Nurse Practitioner PastSince Apr 1, 2025 Accepting new patients

Locations

1919 Lincoln Way
Ste 110
Coeur D Alene, ID 83814
Phone (208) 625-4515

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 1600
Post Falls, ID 83854
Phone (208) 625-4965

Interoperability endpoints

  • Direct secure messaging: jgreensides610073@direct.multicare.org

Organizations & group practices 4

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 2

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": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1689469991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 W HIGHLAND DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838149740",
            "telephone_number": "208-691-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LINCOLN WAY STE 110",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142527",
            "telephone_number": "208-625-4515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Mullan Ave Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838546054",
            "country_code": "US",
            "telephone_number": "208-625-4965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENSIDES",
        "first_name": "JESSICA",
        "middle_name": "AUBRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "8371858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.