DR. KELLY PAGE PALMER D.O.
NPI 1184780694
Psychiatry & Neurology - Child & Adolescent Psychiatry in Blackfoot, ID

Active since December 29, 2006PECOS EnrolledAccepts Medicare Assignment
700 EAST ALICE STREET, BLACKFOOT, ID 83221(208) 785-8517(208) 785-8516 Get Directions Write a Review

NPPES record last updated: August 14, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kelly Page Palmer D.o. NPPES

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

DR. KELLY PAGE PALMER D.O. (NPI 1184780694) is an individual child & adolescent psychiatry provider in Blackfoot, Idaho, licensed in Idaho (O-144) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (1984).

NPPES Registry Identity

NPI1184780694
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. KELLY PAGE PALMERCredential: D.O.
Location Address700 EAST ALICE STREETBlackfoot, ID 83221-0400
Mailing AddressPo Box 400, 700 East AliceBlackfoot, ID 83221-0400 · (208) 785-8517 · Fax (208) 785-8516
Fax(208) 785-8516
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 1984
Enumeration DateDecember 29, 2006
Last NPPES UpdateAugust 14, 2012
NPI 1184780694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License Licensed in ID · O-144
Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

700 EAST ALICE STREET, Blackfoot, ID 83221

Other Identifiers 2

Medicaid0033991ID
Medicaid003398400ID

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly Page Palmer D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991879892
PECOS Enrollment IDI20200130001510
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
700 EAST ALICE STREET, STATE HOSPITAL SOUTH PHARMACY
BLACKFOOT, ID 83221
Pharmacy
700 EAST ALICE STREET
BLACKFOOT, ID 83221

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 Palmer's NPI number?

The NPI number for Kelly Palmer is 1184780694. It was assigned to this individual provider in the NPPES registry on December 29, 2006.

Where is Kelly Palmer located?

Kelly Palmer practices at 700 East Alice Street, Blackfoot, ID 83221. The listed phone number is (208) 785-8517.

What is Kelly Palmer's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Kelly Palmer enrolled in Medicare?

Yes. Kelly Palmer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Palmer was last updated on August 14, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.