DR. TRACI ALENE KETTLE
NPI 1679622971
Marriage & Family Therapist in Idaho Falls, ID
About Dr. Traci Alene Kettle NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TRACI ALENE KETTLE (NPI 1679622971) is an individual marriage & family therapist in Idaho Falls, Idaho, licensed in Idaho (4694) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Traci Alene Kettle 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.
Medicare Billing Reassignment
Medicare enrollment records show Traci Kettle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Idaho Falls, ID 83401
- Reassigned Medicare billing, Idaho enrollment
- 4 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Traci Kettle's NPI number?
The NPI number for Traci Kettle is 1679622971. It was assigned to this individual provider in the NPPES registry on January 9, 2007.
Where is Traci Kettle located?
Traci Kettle practices at 211 S Woodruff Ave Ste A3, Idaho Falls, ID 83401. The listed phone number is (208) 524-4818.
What is Traci Kettle's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Traci Kettle enrolled in Medicare?
Yes. Traci Kettle 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.
Which organization bills Medicare for Traci Kettle's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Traci Kettle reassigns Medicare benefits to Willow Sage Services LLC (Idaho Falls, ID). The 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 Traci Kettle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Traci Kettle accept?
Health plans from Molina Healthcare, PacificSource Health Plans, Providence Health Plan, Select Health and University of Utah Health Plans list Traci Kettle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Traci Kettle was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Dr. Traci Alene Kettle · NPI 1679622971
Marriage & Family Therapist provider in Idaho Falls, Idaho. Individual provider, active in the CMS NPPES registry since January 9, 2007.
## Identity
- **NPI:** 1679622971 (Entity type: Individual)
- **Enumerated:** January 9, 2007
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 4694 (Idaho)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 211 S WOODRUFF AVE STE A3, Idaho Falls, ID 83401-4865
- **Phone:** (208) 524-4818
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Willow Sage Services LLC (NPI 1538611652, Idaho Falls, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** December 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679622971) · Data from the CMS NPPES public registry.