MRS. CRYSTA KIMES (NPI# 1184115735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184115735 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTA KIMES |
| Other Name | CRYSTA KIMES |
| Credential | PA |
| Practice Address |
910 Nw 16th St Ste 101 Fruitland ID 83619-2265 |
| Mailing Address |
18616 Easter Peak Ave Nampa ID 83687-8115 |
| Practice Telephone | 2084528000 |
| Mailing Telephone | 2088509300 |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
910 NW 16TH ST STE 101 |
| City | FRUITLAND |
| State | ID |
| Zip Code | 83619-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154563948 | Becky Jean Wolery | Social Worker | 910 Nw 16th St Ste 101, Fruitland, ID 83619 | 2009-03-25 |
| 1982174199 | Kristyn L Martin | Nurse Practitioner | 910 Nw 16th St Ste 101, Fruitland, ID 83619-2265 | 2018-11-30 |
| 1497172555 | Christina Heninger Benson | Physician Assistant | 910 Nw 16th St Ste 101, Fruitland, ID 83619-2265 | 2014-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322382 | Dallin Scott Wilkes | Physical Therapist | 2175 N Whitley Dr., Fruitland, ID 83619 | 2020-07-01 |
| 1659925113 | Treasure Valley Classical Academy | Local Education Agency (LEA) | 500 Sw 3rd Street, Fruitland, ID 83619 | 2019-08-01 |
| 1083146559 | Total Renal Care, Inc. | Clinic/Center | 815 Nw 13th St, Fruitland, ID 83619 | 2017-04-03 |
| 1740426196 | John Wesley Linhart | Physical Therapist | 1116 Nw 16th Street, Fruitland, ID 83619 | 2009-01-06 |
| 1528263670 | Snake River Dermatology, Pa | Dermatology | 1611 N Whitley Dr, #7, Fruitland, ID 83619 | 2007-06-19 |
| 1568591204 | John Linton Close | Registered Nurse | 1509 N Whitley Drive, Suite 5, Fruitland, ID 83619 | 2007-03-05 |
| 1629110671 | Payette School Dist #373 | Local Education Agency (LEA) | 303 Sw 3rd Street, Fruitland, ID 83619 | 2007-02-13 |
| 1912075839 | William Frederick Martsch | Dentist | 315 N. Whitley, Fruitland, ID 83619 | 2006-11-30 |
| 1992880132 | Ryan David Hillam | Dentist | 1820 N.whitley Drive, Fruitland, ID 83619 | 2006-10-26 |
| 1285723460 | Kurt E Kracaw | Family Medicine | 910 Nw 16th St, Ste 101, Fruitland, ID 83619 | 2006-10-12 |
| Find all providers in zip 83619 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290359 | Jared Anthony Bradford | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2019-11-26 |
| 1396106928 | Jordan Elise Finnegan | Physician Assistant | 910 Nw 16th St, Ste 101, Fruitland, ID 83619-2265 | 2016-03-09 |
| 1083086870 | Charles Edward Brioschi Jr. | Physician Assistant | 910 Nw 16th Street, Ste 205, Fruitland, ID 83619-2265 | 2015-10-20 |
| 1982074696 | Brett Johansen | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2015-10-07 |
| 1205103389 | Bradley James Heninger | Physician Assistant | 910 Nw 16th Street, Ste 205, Fruitland, ID 83619 | 2011-11-17 |
| 1881685642 | Sean P Hackett | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217911 | David Jeffrey Hanson | Physician Assistant | 740 Mckinley Ave Ste 100, Kellogg, ID 83837-2693 | 2019-10-18 |
| 1871060681 | Travis Henman | Physician Assistant | 1404 Pomerelle Ave Ste 150, Burley, ID 83318-2012 | 2018-10-30 |
| 1952889685 | Cody Mattingly | Physician Assistant | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2018-08-03 |
| 1992174072 | Alexa Rhea | Physician Assistant | 2841 Juniper Dr Ste 2, Lewiston, ID 83501-4719 | 2015-09-18 |
| 1043689441 | Derek R Wynn | Physician Assistant | 607 W Main Street, Grangeville, ID 83530 | 2015-09-16 |
| 1407223274 | Michael Kenneth Wucinich | Physician Assistant | 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 | 2015-08-28 |
| 1811364177 | Ashley Laren Popadics | Physician Assistant | 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 | 2015-08-21 |
| 1073915963 | Jessica Bishop | Physician Assistant | 1499 W Hays St, Boise, ID 83702-5029 | 2014-09-23 |
| 1447652813 | Jessea Camille Whitlow | Physician Assistant | 2392 Addison Ave E, Twin Falls, ID 83301-6745 | 2014-09-17 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. CRYSTA KIMES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.