Katrina M. McKellips, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O-1268 Issued in ID

Practice address

209 Forest St
McCall, ID 83638-5256

Phone

(208) 634-2225

NPI assigned

Jul 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic - McCall LLCGroup PAC ID 7618127994, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Home Care and Hospice Home health agency, Meridian, ID, CCN 137028
• St Luke'S McCall Hospital, McCall, ID, CCN 131312
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• St Lukes Clinic - McCall LLC

  • Family Medicine Physician
  • McCall, ID
  • NPI 1881982510
  Medicare reassignment Care Compare group NPD
• St Lukes McCall, LTD

  • Family Medicine Physician
  • McCall, ID
  • NPI 1336457738
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Luke'S Regional Medical Center

  • Home Health Agency
  • Meridian, ID
  • NPI 1306945985
  Care Compare affiliation
• St Lukes McCall LTD

  • Critical Access Hospital
  • McCall, ID
  • NPI 1235447970
  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558742400000",
    "number": "1922482470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FOREST ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385256",
            "telephone_number": "208-634-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FOREST ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385256",
            "telephone_number": "208-634-2225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 Martin Luther King Jr. Way",
            "address_2": "Tacoma Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054238",
            "country_code": "US",
            "telephone_number": "253-792-6680",
            "fax_number": "253-403-2915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKELLIPS",
        "first_name": "KATRINA",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2019-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan McCandless, RLD
• Connie McClaran, R.N.
• Ashley E McCoy, LMFT
• Jacklyn Zastrow McDonald, CCC-SLP
• Kathleen McGowan, DC
• Eric Mikkelsen, LAMFT
• Meghan Eileen Minshall, LPC
• Jennifer Moon, MA
• Thomas L Moore, LCPC
• Irwin Mulnick, D.C., C.C.S.P.

• Family Medicine Physician in McCall, ID
• Providers in McCall, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.