NPI age
5 years
Enumerated 2021-04-20
● Active
Type 1 · Individual
Krista Marie Kelly, PA-C
Kelly is 1 of 1 physician assistant providers in Mountain Home Afb and 1 of 387 in Idaho.
Primary specialty
Physician Assistant
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2025-04-28
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 387 active physician assistant providers in Idaho.
NPI age
5 years
↓ 10 yr below median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-04Enumerated in NPPES
2021
2026
Where they practice
Practice location
90 Hope Dr
Mountain Home Afb, ID 836481057
Mailing address
90 Hope Dr Bldg 6000
Mountain Home Afb, ID 836481062
Specialties
-
Physician Assistant PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1204799 | NCCPA |
Practice context
Part of a multi-provider practice. 30 other active providers share this practice address in NPPES.
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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.