NPI age
20 years
Enumerated 2006-03-08
● Active
Type 1 · Individual
Kelly Marie Landle, P.A.-C
Landle is 1 of 1 physician assistant providers in Kendrick and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
ID, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2019-04-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
20 years
↑ 11 yr above median (9 yr)
State licenses
2 states
Top 81% — 19% of peers are multi-state
Subspecialties
2
In the 35% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-03Enumerated in NPPES
2006
2026
Where they practice
Practice location
606 E Main St
Kendrick, ID 83537
Mailing address
700 S Main St
Moscow, ID 838433046
Additional practice locations
1 secondary location on file with NPPES.
Location 2
320 Warner Dr
Lewiston, ID 835014441
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...
-
Physician AssistantDefinition to come...
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Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806673600 | |
| 01 | 970027265 | RAILROAD MEDICARE |
| 01 (WA) | 0141613 | STATE WORK COMP |
| 05 (WA) | 8201634 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 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.