Jon R Kattenhorn, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M-3893 Issued in ID

Practice address

1072 N Liberty St
Suite 100
Boise, ID 83704-8708

Phone

(208) 302-1200

Fax

(208) 302-1255

NPI assigned

May 20, 2006

Last updated

Nov 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1881648251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-1200",
            "fax_number": "208-302-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048708",
            "telephone_number": "208-302-1200",
            "fax_number": "208-302-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTENHORN",
        "first_name": "JON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M3893",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-3893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010005174",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "38935",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003785900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.