Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John Kodatt, MD

Individual provider Emergency Medicine Physician · NPI 1083354039

Dr. John Kodatt, MD is a Family Practice in Nampa, Idaho. Qualified in 2022, 4 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho and Kentucky.

Years since qualifying
4
Licensed in
ID, KY
In the registry since
2022
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1510 12th Ave Rd Ste 200
Nampa, ID 83686-6946
Phone: (208) 302-6800
Fax: (208) 302-6855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 712 Aviation Way, Caldwell, ID 83605-1154 — (208) 302-7100
  • 1325 N Race St, Glasgow, KY 42141-3427 — (270) 651-4865

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2171959 (ID)
Emergency Medicine Physician Taxonomy 207P00000X · Licence R6281 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083354039
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2022
Last updated in NPPESSeptember 18, 2025
Certification dateSeptember 18, 2025
Mailing addressPo Box 190930, Boise, ID 83719-0930

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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