Brian Dennis Kittelson, DNP, ARNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-958 Issued in ID

Practice address

875 S Vanguard Way
Meridian, ID 83642-7552

Phone

(208) 884-2922

Fax

(208) 884-2923

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Sleep Wake Idaho PLLC

  • Sleep Medicine (Internal Medicine) Physician
  • Boise, ID
  • NPI 1700642683
  Medicare reassignment NPD
• Tellica Imaging, LLC

  • Radiology Clinic/Center
  • Boise, ID
  • NPI 1760197198
  Medicare reassignment NPD
• Southern Idaho Health Partners LLC

  • General Practice Physician
  • Meridian, ID
  • NPI 1952701401
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Spanish Fork, UT
  • NPI 1518727734
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1730234345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427552",
            "telephone_number": "208-884-2922",
            "fax_number": "208-884-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427552",
            "telephone_number": "208-884-2922",
            "fax_number": "208-884-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7272 W Potomac Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049149",
            "country_code": "US",
            "telephone_number": "208-884-2922",
            "fax_number": "208-884-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITTELSON",
        "first_name": "BRIAN",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "DNP, ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IDAHO BOARD OF NURSING",
            "identifier": "NP-958",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Peter Kinnaman
• Claire Kiota
• Bryce Jacob Kirkman, D.O.
• Savannah Kisling- Scrima, PT, DPT
• Brian Craig Kitamura, M.D.
• Colleen Gray Klabo, PSYD
• Vanessa M Klaus, FNP
• Kimberly A Kleaveland, FNP
• Eric W Klein, M.D.,MPH, TM
• Kelly Marie Klinger, COTA/L

• Family Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.