Individual provider Active NPI

Kelly Marie McMurtrey, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1356656441
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-34145 Issued in ID
Practice address
1465 Hoopes Ave
Idaho Falls, ID 83404-5772
Phone
(208) 522-5545
Fax
(208) 528-6773
NPI assigned
Aug 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-34145 ID Primary

Addresses

Primary practice location

1465 Hoopes Ave
Idaho Falls, ID 83404-5772

Mailing address

3822 E 214 N
Rigby, ID 83442-5410
Phone (208) 351-7827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150325000503 ID Practitioner - Clinical Social Worker 6103143441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Country Behavioral HealthGroup PAC ID 0648454587, 44 clinicians

Practice addresses (Care Compare)

1248 E 17TH St
Idaho Falls, ID 83404-6147
Phone (208) 542-1026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-34145IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Behavioral Health CurrentSince Jul 20, 2020 Accepting new patients
Ashton Memorial, Inc. Current Accepting new patients
Ashton Memorial, Inc. CurrentSince Feb 10, 2015 Accepting new patients
Ashton Memorial, Inc. CurrentSince Feb 10, 2015 Accepting new patients
High Country Behavioral Health CurrentSince Jul 20, 2020 Accepting new patients
Help, Inc. Social Worker Past Accepting new patients

Locations

1248 E 17th St
Idaho Falls, ID 83404
Phone (208) 542-1026

420 S 4th Ave
Pocatello, ID 83201
Phone (208) 478-9081

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1356656441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 E 214 N",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425410",
            "telephone_number": "208-351-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 HOOPES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045772",
            "telephone_number": "208-522-5545",
            "fax_number": "208-528-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURTREY",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-34145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.