| Kristine P Kingery, PA-C | |
|
381 S Middleton Rd Ste B, Middleton, ID 83644-5369 | |
| (208) 585-6311 | |
| Not Available |
| Full Name | Kristine P Kingery |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 21 Years |
| Location | 381 S Middleton Rd Ste B, Middleton, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679517155 | NPI | - | NPPES |
| 807305900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA582 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Horizon Home Health West | Caldwell, ID | Home health agency |
| West Valley Medical Center | Caldwell, ID | Hospital |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mountain View Hospital Llc | 4486562774 | 272 |
| Entity Name | West Valley Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871673798 PECOS PAC ID: 8729180310 Enrollment ID: O20070228000567 |
| Entity Name | Community Care West Side LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295009785 PECOS PAC ID: 3678738218 Enrollment ID: O20120703000554 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristine P Kingery, PA-C Po Box 277976, Atlanta, GA 30384-7976 Ph: Not Available | Kristine P Kingery, PA-C 381 S Middleton Rd Ste B, Middleton, ID 83644-5369 Ph: (208) 585-6311 |
Mr. Brenton James Noel, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 381 S Middleton Rd Ste B, Middleton, ID 83644 Phone: 208-585-6311 |
Kristin A Christensen, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 381 S Middleton Rd Ste B, Suite 115, Middleton, ID 83644 Phone: 208-585-6311 Fax: 208-585-6221 |
Mrs. Jennice M Cordova, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 201 S 1st Ave E, Middleton, ID 83644 Phone: 208-585-6311 Fax: 208-585-6221 |