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KELLY D HARRIS DC PA
NPI 1174889372
Chiropractor in Idaho Falls, ID

Active since April 02, 2012
211 S WOODRUFF AVE STE A1, IDAHO FALLS, ID 83401(208) 522-2122(208) 529-5588 Get Directions Write a Review

NPPES record last updated: April 2, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly D Harris Dc Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY D HARRIS DC PA (NPI 1174889372) is a healthcare organization registered as a chiropractor in Idaho Falls, Idaho and active in the NPI registry since April 2012. The organization lists Kelly D Harris, Owner, as its authorized official.

NPPES Registry Identity

NPI1174889372
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameKELLY D HARRIS DC PA
Location Address211 S WOODRUFF AVE STE A1Idaho Falls, ID 83401-4865
Mailing Address211 S Woodruff Ave Ste A1Idaho Falls, ID 83401-4865 · (208) 522-2122 · Fax (208) 529-5588
Phone(208) 522-2122
Fax(208) 529-5588
Organization SubpartNo
Authorized OfficialKelly D HarrisOwner · (208) 522-2122
Enumeration DateApril 2, 2012
✔ NPI 1174889372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in ID · CHIA511
Definition
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.
211 S WOODRUFF AVE STE A1, Idaho Falls, ID 83401
Open in Google Maps ↗

Other Identifiers 3

Medicare PIN1672138
Medicaid001404500ID
Medicare UPINT44518

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly D Harris Dc Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIdahoEnrollment IDO20120612000184Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kelly D Harris Dc PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kelly Harris, D.C.
Chiropractic
NPI 1851467559
211 S WOODRUFF AVE STE B
Idaho Falls, ID 83401
(208) 522-2122
✔ Accepts Medicare0.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly D Harris Dc PA's NPI number?

The NPI number for Kelly D Harris Dc PA is 1174889372. It was assigned to this organization in the NPPES registry on April 2, 2012.

Where is Kelly D Harris Dc PA located?

Kelly D Harris Dc PA is located at 211 S Woodruff Ave Ste A1, Idaho Falls, ID 83401. The listed phone number is (208) 522-2122.

What is Kelly D Harris Dc PA's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kelly D Harris Dc PA enrolled in Medicare?

Yes. Kelly D Harris Dc PA is registered in the Medicare PECOS enrollment system.

When is Kelly D Harris Dc PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Kelly D Harris Dc PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Kelly D Harris Dc PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kelly D Harris Dc PA was last updated on April 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.