Individual provider Active NPI

Kathy Jean Hemming, PA-C

  • Physician Assistant
  • Ammon, ID
National Provider Identifier
1700817442
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
352013-1206 Issued in UT
Practice address
1675 Curlew Drive
Ammon, ID 83406
Phone
(208) 523-5319
Fax
(208) 523-5627
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 352013-1206 UT Primary

Addresses

Primary practice location

1675 Curlew Drive
Ammon, ID 83406

Mailing address

1675 Curlew Drive
Ammon, ID 83406
Phone (208) 523-5319

Other names 1

  • Mrs. Kathy Jean Cook Former name

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
I20050516000687 ID Practitioner - Physician Assistant 2567403926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Full Spectrum Psychology LLCGroup PAC ID 8325536931, 4 clinicians

Practice addresses (Care Compare)

675 E Anderson St
Idaho Falls, ID 83401-2020
Phone (208) 432-1976

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
4 Pillars of Success LLC Clinic/Center CurrentSince Nov 21, 2017 Accepting new patients
Full Spectrum Psychology LLC Clinic/Center CurrentSince Feb 7, 2026 Accepting new patients

Locations

1675 Curlew Dr
Ammon, ID 83406
Phone (208) 523-5319

675 E Anderson St
Idaho Falls, ID 83401
Phone (208) 432-1976

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1700817442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DRIVE",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-523-5319",
            "fax_number": "208-523-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DRIVE",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-523-5319",
            "fax_number": "208-523-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMMING",
        "first_name": "KATHY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "352013-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "COOK",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.