● Active Type 1 · Individual

Kathleen Anneke, PA-C

Physician Assistant·Boise, ID· NPI 1083837942 · Enumerated 2007 · 19 years on NPI

Anneke is 1 of 36 physician assistant providers in Boise and 1 of 97 in Idaho.

NPI age

19 years

Enumerated 2007-04-10

Primary specialty

Physician Assistant

Plus 2 subspecialties

Licensed in

1 state

Status

Active

No deactivations on record

Last NPPES update

2024-02-27

Source: monthly bulk 2026-05

Sole proprietor

May be part of a larger org

How this provider compares

Across 97 active physician assistant providers in Idaho.

NPI age

19 years

↑ 6 yr above median (13 yr)

State licenses

1 state

23% of peers hold multiple states

Subspecialties

In the 56% of peers with subspecialties

NPI lifetime · 2007 → 2026

2007-04Enumerated in NPPES

2007 2026

Where they practice

Practice location

1072 N Liberty St Ste 100

Boise, ID 837048708

📞 2083021200fax 2083021255

Mailing address

Po Box 190930

Boise, ID 837190930

📞 2083029342fax 2083675180

Additional practice locations

2 secondary locations on file with NPPES.

Location 2

165 Maa St

Kahului, HI 967323603

📞 8084467120fax 8084467121

Location 3

875 S Vanguard Way Ste 200

Meridian, ID 836428542

📞 2084633000

Specialties

Physician Assistants & Advanced Practice Nursing Providers › Physician Assistant

Physician Assistant Primary

Definition to come...

ID license #PA-378 taxonomy 363AS0400X
Physician Assistant

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...

ID license #PA-378 taxonomy 363A00000X

Identifiers

Type	Value	Notes
05 (ID)	806217300

Practice context

Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.

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How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.