MAVERICK MITTON (FNP-C) – Family Nurse Practitioner, NPI 1396602249

MAVERICK MITTON (FNP-C) is a healthcare provider. based in Kimberly, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 5671698 (ID). The NPI Number for MAVERICK MITTON (FNP-C) is 1396602249

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
MAVERICK MITTON (FNP-C)
NPI
1396602249
Phone
(808) 489-6202
Address
1550 CAYUSE CREEK DR
Enumeration Date
5 January 2026
Last Update Date
9 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2025 (1 year ago)
PAC ID
5395229876
Group Practice PAC ID
1052217478
Professional Enrollment ID
I20260323002606
Address ID
ID833015819TW775XXWXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

1,802 NURSE PRACTITIONER in ID

Provider Addresses for MAVERICK MITTON (FNP-C)

  • 1550 CAYUSE CREEK DR

    KIMBERLY, ID 833415126

    Phone: (808) 489-6202

    Type: Mailing

  • 775 POLE LINE RD

    TWIN FALLS, ID 833013036

    Phone: (208) 814-1000

    Type: Location

  • 190 E BANNOCK ST

    BOISE, ID 837126241

    Phone:

    Type: Mailing

  • 775 POLE LINE RD W STE 103

    TWIN FALLS, ID 833015819

    Phone: (208) 814-8375

    Fax: (208) 814-8376

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83341)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052217478View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)VA
Certified Registered Nurse Anesthetist (Crna)ID
Clinical PsychologistND
A N E S T H E S I O L O G YID
-UT
Diagnostic RadiologyOR
Physician AssistantID
Family PracticeID
O B S T E T R I C S/ G Y N E C O L O G YID
Nurse PractitionerID

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Frequently asked questions

What identifier follows MAVERICK MITTON (FNP-C) across health systems?
The NPI 1396602249 uniquely identifies MAVERICK MITTON (FNP-C) in U.S. healthcare data.
Quick check: is MAVERICK MITTON (FNP-C) active?
Public NPPES data shows MAVERICK MITTON (FNP-C) with an active NPI status right now.
What services align with MAVERICK MITTON (FNP-C)'s listing?
MAVERICK MITTON (FNP-C)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit MAVERICK MITTON (FNP-C) in Kimberly, Idaho?
For routing, start with Kimberly, Idaho for MAVERICK MITTON (FNP-C), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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