NPI age
19 years
Enumerated 2007-02-27
● Active Type 2 · Organization
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg is 1 of 326 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Gussenhoven
Program Manager
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 326 active clinic/center providers in Idaho.
NPI age
19 years
↑ 14 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
35 Wildcat Way Ste B
Kellogg, ID 838372261
Mailing address
35 Wildcat Way Ste B
Kellogg, ID 838372261
Authorized official
Cora Jo Gussenhoven
Program Manager
📞 2087691406
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | HW256 | BLUE CROSS OF IDAHO |
| 05 (ID) | 8073520 | |
| 01 | 000010018348 | BLUE SHIELD |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.