Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KELLY RUSSELL MSN,RN,FNP-BC
NPI 1669938320
Nurse Practitioner in Boise, ID

Q: What is Kelly Russell's NPI number?

The NPI number for Kelly Russell is 1669938320. It was assigned to this individual provider in the NPPES registry on February 18, 2019.

Q: What is Kelly Russell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Russell was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 18, 2019PECOS Enrolled

900 N LIBERTY ST STE 101, BOISE, ID 83704(208) 367-8787 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2026, Feb 18, 2019 (2 updates tracked since 2019).

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About Kelly Russell Msn,rn,fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY RUSSELL MSN,RN,FNP-BC (NPI 1669938320) is an individual nurse practitioner in Boise, Idaho, licensed in Idaho (79075) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669938320

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKELLY RUSSELLCredential: MSN,RN,FNP-BC

Location Address900 N LIBERTY ST STE 101Boise, ID 83704-8858

Mailing AddressPo Box 190930Boise, ID 83719-0930 · (208) 302-9342 · Fax (208) 367-5180

Phone(208) 367-8787

Sole ProprietorNo

Enumeration DateFebruary 18, 2019

Last NPPES UpdateJune 29, 20262 updates tracked since enumeration

NPPES CertifiedJune 29, 2026

✔ NPI 1669938320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in ID · 79075

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95008457 (CA)

900 N LIBERTY ST STE 101, Boise, ID 83704

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Russell Msn,rn,fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Russell's NPI number?

The NPI number for Kelly Russell is 1669938320. It was assigned to this individual provider in the NPPES registry on February 18, 2019.

Where is Kelly Russell located?

Kelly Russell practices at 900 N Liberty St Ste 101, Boise, ID 83704. The listed phone number is (208) 367-8787.

What is Kelly Russell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelly Russell enrolled in Medicare?

Yes. Kelly Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Russell was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.