NPI age
10 years
Enumerated 2015-10-15
● Active
Type 1 · Individual
MR. Kelly Meacham, PA-C
Meacham is 1 of 105 physician assistant providers in Idaho Falls and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-10-15
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
10 years
≈ at median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-10Enumerated in NPPES
2015
2026
Where they practice
Practice location
3389 Merlin Dr
Idaho Falls, ID 834047405
Mailing address
3389 Merlin Dr
Idaho Falls, ID 834047405
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.