DR. RENEE GAULT DNP, PMHNP-BC
NPI 1912489980
Nurse Practitioner - Psychiatric/Mental Health in Pocatello, ID

Q: What is Renee Gault's NPI number?

The NPI number for Renee Gault is 1912489980. It was assigned to this individual provider in the NPPES registry on September 5, 2018.

Q: What is Renee Gault's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Renee Gault was last updated on November 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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 September 05, 2018PECOS Enrolled

444 HOSPITAL WAY STE 477, POCATELLO, ID 83201(208) 233-7832(208) 233-7835 Get Directions Write a Review

NPPES record last updated: November 21, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 21, 2018, Sep 5, 2018 (2 updates tracked since 2018).

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About Dr. Renee Gault Dnp, Pmhnp-bc NPPES

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

DR. RENEE GAULT DNP, PMHNP-BC (NPI 1912489980) is an individual psychiatric/mental health provider in Pocatello, Idaho, licensed in Idaho (59582) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1912489980

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameDR. RENEE GAULTCredential: DNP, PMHNP-BC

Location Address444 HOSPITAL WAY STE 477Pocatello, ID 83201-2744

Mailing Address444 Hospital Way Ste 477Pocatello, ID 83201-2744 · (208) 233-7832 · Fax (208) 233-7835

Phone(208) 233-7832

Fax(208) 233-7835

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 5, 2018

Last NPPES UpdateNovember 21, 20182 updates tracked since enumeration

✔ NPI 1912489980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in ID · 59582

444 HOSPITAL WAY STE 477, Pocatello, ID 83201

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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)

Dr. Renee Gault Dnp, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123366259

PECOS Enrollment IDI20260512001105

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 83201 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.

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMBER CAROLYNN MALAY BS

Case Manager/Care Coordinator