Individual provider Active NPI

Corenne Koerwitz, NP

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1770396251
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3671546 Issued in ID
Practice address
190 E Bannock St FL 10
Boise, ID 83712-6241
Phone
(208) 381-5500
Fax
(208) 381-2555
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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 3671546 ID Primary

Addresses

Primary practice location

190 E Bannock St FL 10
Boise, ID 83712-6241

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other names 1

  • Corenne Schultz 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
I20250408003646 ID Practitioner - Nurse Practitioner 8426572769 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
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

222 N 2ND St
Boise, ID 83702-6130

520 S Eagle Rd
Meridian, ID 83642-6355

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3671546IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 20, 2025 Accepting new patients
St Lukes Regional Medical Center PastSince Mar 30, 2025 Accepting new patients

Locations

190 E Bannock St
#10
Boise, ID 83712

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

222 N 2nd St
Ste 215
Boise, ID 83702
Phone (208) 342-2706

190 E Bannock St
Fl 10
Boise, ID 83712
Phone (208) 381-5500

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

520 S Eagle Rd
Ste 1201
Meridian, ID 83642
Phone (208) 706-5988

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.

Hospital & facility affiliations 3

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": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1770396251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST FL 10",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-5500",
            "fax_number": "208-381-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERWITZ",
        "first_name": "CORENNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "3671546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORENNE",
            "last_name": "SCHULTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.