KELLY C PHELPS (NPI# 1831270073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831270073 |
| Entity Type | Individual |
| Full Name | KELLY C PHELPS |
| Credential | MD |
| Practice Address |
203 S Daisy St Salmon ID 83467-0000 |
| Practice Telephone | 2087565600 |
| Practice Fax Number | 2087564169 |
| Mailing Telephone | 2087565600 |
| Mailing Fax Number | 2087564169 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-02-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | M-5808 | ID | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | M5808 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 004220800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184827727 | Kelly D Phelps | Student in an Organized Health Care Education/Training Program | 1367 Stewartstown Rd # X17, Morgantown, WV 26505-8045 | 2007-06-11 |
| 1396065652 | Kelly Phelps | Physical Therapy Assistant | 118 Medical Dr, Carmel, IN 46032-2923 | 2010-06-09 |
| 1356678130 | Kelly Ann Phelps | Counselor | 91 Timberlane Rd, Waynesville, NC 28786-7927 | 2009-11-16 |
| 1396919684 | Kelly Phelps | Speech-Language Pathologist | 185 Charlois Blvd, Winston Salem, NC 27103-1521 | 2008-04-17 |
| 1235353285 | Kelly Phelps | Psychologist | 115 Mill St, Belmont, MA 02478-1041 | 2007-04-12 |
| 1700844925 | Kelly L Phelps | Physician Assistant | 117 E Clark St, Harrisburg, IL 62946-2702 | 2006-05-04 |
| Street Address |
203 S DAISY ST |
| City | SALMON |
| State | ID |
| Zip Code | 83467-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437149887 | Joel V Dye | Anesthesiology | 203 S Daisy St, Salmon, ID 83467-0000 | 2005-10-26 |
| 1245841519 | Megan S Koyle | Occupational Therapist | 203 S Daisy St, Salmon, ID 83467-4709 | 2020-08-11 |
| 1477161693 | Meghan Kratofil | Occupational Therapist | 203 S Daisy St, Salmon, ID 83467-4709 | 2020-07-14 |
| 1255960688 | Tevagene Bragg | Physical Therapy Assistant | 203 S Daisy St, Salmon, ID 83467-4709 | 2020-04-07 |
| 1891324828 | Jeanna Ritter | Speech-Language Pathologist | 203 S Daisy St, Salmon, ID 83467-4709 | 2020-04-02 |
| 1649643594 | Cynthia Grier | Physical Therapist | 203 S Daisy St, Salmon, ID 83467-4709 | 2015-11-01 |
| 1417397001 | Joseph James Krakker IIi | Family Medicine | 203 S Daisy St, Salmon, ID 83467-4709 | 2013-06-27 |
| 1518126119 | River of No Return Anesthesia | Nurse Anesthetist, Certified Registered | 203 S Daisy St, Salmon, ID 83467 | 2008-06-09 |
| 1083776157 | Linda J Powell | Family Medicine | 203 S Daisy St, Salmon, ID 83467-4709 | 2006-12-15 |
| 1851403265 | Steele Memorial Medical Center | General Acute Care Hospital | 203 S Daisy St, Salmon, ID 83467-0000 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010686 | Rocky Mountain Holdings, LLC | Ambulance | 17 Center Hangar Rd, Salmon, ID 83467 | 2020-07-20 |
| 1790204881 | Annah Benedict Dahle | Physical Therapist | Porgy & Petunia's Pediatric Therapy 111 E Lillian, Suite 8, Salmon, ID 83467 | 2017-09-11 |
| 1912436395 | Georgena Yanoff | Occupational Therapist | 516 Main Street #103, Salmon, ID 83467 | 2017-06-08 |
| 1134580525 | Amy Berasi | Specialist | 201 Pole Line Rd, Salmon, ID 83467 | 2016-03-11 |
| 1689098964 | Aspen Meadows Home Care LLC | In Home Supportive Care | 104 South Warpath, Salmon, ID 83467 | 2014-02-07 |
| 1366799827 | Physical Therapy Clinic,inc. | Clinic/Center | 802 Shoup Street, Salmon, ID 83467 | 2012-08-14 |
| 1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
| 1972767531 | Katherine I Contway | Social Worker | 204 Courthouse Dr, Salmon, ID 83467 | 2008-07-14 |
| 1215135017 | Annie J Allen | Acupuncturist | 111 Lillian Street, Suite 211, Salmon, ID 83467 | 2007-07-03 |
| 1992913479 | Steele Memorial Medical Center | Medicare Defined Swing Bed Unit | 203 S. Daisy St., Salmon, ID 83467 | 2007-05-18 |
| Find all providers in zip 83467 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568500544 | Home Touch A Center for Wellness | Family Medicine | 1253 Cemetery Ln, Salmon, ID 83467-5436 | 2007-02-02 |
| 1417397001 | Joseph James Krakker IIi | Family Medicine | 203 S Daisy St, Salmon, ID 83467-4709 | 2013-06-27 |
| 1083776157 | Linda J Powell | Family Medicine | 203 S Daisy St, Salmon, ID 83467-4709 | 2006-12-15 |
| 1962588111 | Samuel D Gardner | Family Medicine | 805 Main St, Salmon, ID 83467-0000 | 2006-10-31 |
| 1023128261 | Diane Zavotsky | Family Medicine | 805 Main St, Salmon, ID 83467-0000 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1750998126 | Story Family Medicine | Family Medicine | 1150 Alturas Dr Ste 101, Moscow, ID 83843-3263 | 2020-09-29 |
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1447880570 | Bore LLC | Family Medicine | 1498 Midway Ave Ste 2, Ammon, ID 83406-4587 | 2020-01-16 |
| 1669038220 | Savannah M Klinginsmith | Family Medicine | 17866 Polara Way, Nampa, ID 83687-9159 | 2019-05-18 |
| 1487218814 | Logan Perkins | Family Medicine | 132 5th Ave W Ste 2, Jerome, ID 83338-1825 | 2019-05-01 |
| 1588227656 | Traci H Permenter | Family Medicine | 943 N Linder Rd Ste 103, Kuna, ID 83634-3395 | 2019-04-15 |
| 1790244424 | Destin Thayne Bep Inc | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.