Kimberly McDermott, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

69417 Issued in ID

Practice address

913 W Canfield Ave
Coeur D Alene, ID 83815-9764

Phone

(208) 819-7103

Fax

(208) 719-0050

NPI assigned

Sep 4, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 7, 2023 through Jun 7, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Chiropractic Plus

  • Chiropractor
  • Priest River, ID
  • NPI 1265677785
  NPD (past)

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1740680131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-819-7103",
            "fax_number": "208-719-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-819-7103",
            "fax_number": "208-719-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "KIMBERLY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "69417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyra Nicole McComas, MD
• Brenna Kolokoff McCrummen, M.D.
• Keith Michael McCullough, PA-C
• Lonnie Earle McCurdie Jr., RPH
• Patrick L. McCurdy, PA-C
• Kaitlyn McDonald, PHARMD
• Shawna Richardson McDonald
• Sydney Claire McDonald
• Madeline McElroy
• Dehra McFaddan, LMSW

• Family Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, 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 Sep 6, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.