Individual provider

Connor Rezzonico, PMHNP

Psychiatric/Mental Health Nurse Practitioner Medicare enrolled

Connor Rezzonico, PMHNP is a Psychiatric/Mental Health Nurse Practitioner in Coeur D Alene, ID, registered under NPI 1063184968. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 1110 W PARK PL STE 222, Coeur D Alene, ID 83814. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

1110 W PARK PL STE 222, Coeur D Alene, ID 83814 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
74368 ID Psychiatric/Mental Health Nurse… primary
AP70005328 WA Psychiatric/Mental Health Nurse…

Licences are recorded in 2 states: ID, WA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
8729458690
Enrollment ID
I20230111000009

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Idaho and Washington. The practice address on file is in Coeur D Alene, ID, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

ID Idaho practice address
Licence
74368
Specialty
Psychiatric/Mental Health Nurse…
Verify with the ID board →
WA Washington
Licence
AP70005328
Specialty
Psychiatric/Mental Health Nurse…
Verify with the WA board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Psychiatric/Mental Health covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LP0808X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Psychiatric/Mental Health

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363LP0808X Psychiatric/Mental Health Nurse Practitioner Psychiatric/Mental Health 74368 ID primary
363LP0808X Psychiatric/Mental Health Nurse Practitioner Psychiatric/Mental Health AP70005328 WA

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1063184968 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateSep 29, 2021
Last updatedMay 20, 2026
StatusActive
Sole proprietorYes
CredentialPMHNP
Practice address 1110 W PARK PL STE 222
Coeur D Alene, ID 83814
(208) 625-7695
Fax (949) 864-3567
This record was updated on May 20, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1063184968 passes the NPI check digit test The final digit 8 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 6 3 1 8 4 9 6
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 3 3 2 8 8 9 3

Sum = 62 · next multiple of 10 = 70 · check digit = 8 · actual last digit = 8

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1063184968?
NPI 1063184968 is the National Provider Identifier assigned to Connor Rezzonico, PMHNP in Coeur D Alene, ID. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Psychiatric/Mental Health cover?
Definition to come...
How do I contact Connor Rezzonico, PMHNP?
The phone number on file with NPPES is (208) 625-7695, last updated May 20, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Connor Rezzonico, PMHNP accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1063184968 a valid number?
Yes. 1063184968 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.