P Praxis·MD
● Active Type 1 · Individual

Robert Todd Gillespie, P.A.

Physician Assistant·Malad City, ID· NPI 1922026467 · Enumerated 2006 · 19 years on NPI
Gillespie is 1 of 4 physician assistant providers in Malad City and 1 of 1263 in Idaho.
NPI age
19 years
Enumerated 2006-07-17
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2011-06-10
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
19 years
↑ 10 yr above median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-07Enumerated in NPPES
2006 2026

Where they practice

Practice location
220 Bannock St, Suite B
Malad City, ID 832521256
📞 2087662600
Mailing address
Po Box 126, Suite B
Malad City, ID 832520126
📞 2087662231fax 2087664819

Specialties

  • Physician Assistant Primary
    A 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...
    ID license #PA205 taxonomy 363A00000X

Identifiers

TypeValueNotes
05 (ID) 805203600
01 (ID) 970011284 RAILROAD MEDICARE PTAN

Practice context

Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.

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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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