NPIMap

Individual provider Active NPI

Valerie Lynn Kellbach Barizo, DDS

  • Dentist
  • Boise, ID
National Provider Identifier
1801829858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-3797 Issued in ID
Practice address
10552 W Garverdale CT
Suite 904
Boise, ID 83704-5412
Phone
(208) 323-2010
Fax
(208) 323-1270
NPI assigned
Jul 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-3797 ID Primary

Addresses

Primary practice location

10552 W Garverdale CT
Suite 904
Boise, ID 83704-5412

Mailing address

10552 W Garverdale CT
Suite 904
Boise, ID 83704-5412
Phone (208) 323-2010

Other identifiers 1

IdentifierTypeStateIssuer
806988300/1208MedicaidID

Other names 1

  • Dr. Valerie L Kellbach Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322000812 ID Order and Referring Only - DentistPractitioner - Dentist 8527365303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vkellbach337638@direct.ochin.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801829858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10552 W GARVERDALE CT",
            "address_2": "SUITE 904",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045412",
            "telephone_number": "208-323-2010",
            "fax_number": "208-323-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10552 W GARVERDALE CT",
            "address_2": "SUITE 904",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045412",
            "telephone_number": "208-323-2010",
            "fax_number": "208-323-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLBACH BARIZO",
        "first_name": "VALERIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806988300/1208",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "KELLBACH",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.