P Praxis·MD
● Active Type 1 · Individual

MR. Kim E. Tillery, RPH

Pharmacist·Twin Falls, ID· NPI 1508096777 · Enumerated 2009 · 16 years on NPI
Tillery is 1 of 7 pharmacist providers in Twin Falls and 1 of 80 in Idaho.
NPI age
16 years
Enumerated 2009-07-21
Primary specialty
Pharmacist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-07-21
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 80 active pharmacist providers in Idaho.

NPI age
16 years
↑ 6 yr above median (9 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
31% of peers hold subspecialties

NPI lifetime · 2009 → 2026

2009-07Enumerated in NPPES
2009 2026

Where they practice

Practice location
2638 Longbow Dr
Twin Falls, ID 833018946
📞 2087354076fax 2083244599
Mailing address
2638 Longbow Dr
Twin Falls, ID 833018946
📞 2087354076fax 2083244599

Specialties

  • Pharmacist Primary
    Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
    ID license #P4585 taxonomy 1835P0018X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

Recently enumerated nearby: 1 new pharmacist provider has been added in Twin Falls in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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