NPI age
19 years
Enumerated 2007-01-30
● Active
Type 1 · Individual
David J Kelly, MD
Kelly is 1 of 31 family medicine providers in Eagle and 1 of 1691 in Idaho.
Primary specialty
Family Medicine
Plus 3 subspecialties
Licensed in
ID, OR, WI
3 states
Status
Active
No deactivations on record
Last NPPES update
2024-04-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1691 active family medicine providers in Idaho.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
3 states
Top 85% — 14% of peers are multi-state
Subspecialties
0
31% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Practice location
3217 W Bavaria St
Eagle, ID 836165171
Mailing address
Po Box 190930
Boise, ID 837190930
Additional practice locations
1 secondary location on file with NPPES.
Location 2
929 Sw Simpson Ave, Ste 300
Bend, OR 977023118
Specialties
-
Family Medicine PrimaryFamily 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807768800 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new family medicine provider has been added in Eagle in the last 180 days.
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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.