KELLY D HARRIS DC PA (NPI# 1174889372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174889372 |
| Entity Type | Organization |
| Organization Name | KELLY D HARRIS DC PA |
| Practice Address |
211 S Woodruff Ave Ste A1 Idaho Falls ID 83401-4865 |
| Practice Telephone | 2085222122 |
| Practice Fax Number | 2085295588 |
| Mailing Telephone | 2085222122 |
| Mailing Fax Number | 2085295588 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Authorized Official Name | DR. KELLY D HARRIS (OWNER) |
| Authorized Official Telephone | 2085222122 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIA511 | ID | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 001404500 | 05 |
| Street Address |
211 S WOODRUFF AVE STE A1 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-4865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639655970 | Derek C Calaway | Chiropractor | 661 S Woodruff Ave, Idaho Falls, ID 83401-3362 | 2018-07-18 |
| 1275969206 | Chad Robert Webb | Chiropractor | 1797 W Broadway St, Idaho Falls, ID 83402-3045 | 2013-09-23 |
| 1316286081 | Fit 4 Life Chiropractic LLC | Chiropractor | 2086 E 25th St, Idaho Falls, ID 83404-6490 | 2013-01-31 |
| 1558500652 | Jaman B Brunson | Chiropractor | 3092 S 25th E, Idaho Falls, ID 83404-6520 | 2009-02-12 |
| 1861639221 | Justin Tyrell Hammon | Chiropractor | 2105 Niagara St, Idaho Falls, ID 83404-8026 | 2009-01-07 |
| 1649441726 | Wade Kelly Price | Chiropractor | 275 N Woodruff Ave, Idaho Falls, ID 83401-4303 | 2008-03-17 |
| 1184801946 | Wight Chiropractic, Pa | Chiropractor | 333 S. Woodruff Ave, Idaho Falls, ID 83401 | 2008-01-23 |
| 1477739639 | Sermon Chiropractic P.a. | Chiropractor | 3092 S. 25th E., Idaho Falls, ID 83404 | 2008-01-17 |
| 1437285632 | Kerry Vince Young | Chiropractor | 1846 1st St, Idaho Falls, ID 83401-4415 | 2007-02-24 |
| 1447399076 | Craig B Lords | Chiropractor | 335 River Pkwy, Idaho Falls, ID 83402-3315 | 2007-02-06 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on KELLY D HARRIS DC PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.