Beverly Mielke Kocarnik, MD, MPH

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD 60234086 Issued in WA

Practice address

500 W Fort St
CRH 2ND Floor
Boise, ID 83702-4501

Phone

(208) 422-1018

NPI assigned

Jul 15, 2008

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

Other names 1

• Beverly Ann Mielke Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1962666438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "CRH 2ND FLOOR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "CRH 2ND FLOOR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCARNIK",
        "first_name": "BEVERLY",
        "middle_name": "MIELKE",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60234086",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WA",
            "license": "MD 60234086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "MIELKE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charlotte Knuth, LMSW
• Christina M Knutson, MD
• Makala A Knutson, LCSW
• Antonia Wheeler Kober, LCSW
• Teresa Bernadette Kobza, RD LD
• Russell M Kocemba, MD
• Christopher Michael Koch, LCSW
• Cierra Kocik, DMD
• Devoney Kodad, LCSW
• Chelsey R Koehler, PA

• Endocrinology, Diabetes & Metabolism Physician in Boise, ID
• Providers in Boise, ID by specialty
• Endocrinology, Diabetes & Metabolism Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.