NPI age
10 years
Enumerated 2015-12-10
● Active
Type 1 · Individual
Kyle Hollenback
Hollenback is 1 of 3 physician assistant providers in Mountain Home and 1 of 387 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-02-19
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
10 years
↓ 5 yr below median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-12Enumerated in NPPES
2015
2026
Where they practice
Practice location
2280 American Legion Blvd
Mountain Home, ID 836473142
Mailing address
486 W 1st Ave
Glenns Ferry, ID 836232701
Additional practice locations
1 secondary location on file with NPPES.
Location 2
486 W 1st Ave
Glenns Ferry, ID 836232701
Specialties
-
Physician Assistant PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 13 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.