Individual provider Active NPI

Kelsie Krahenbuhl

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1740879220
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2103 Issued in ID
Practice address
3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546
Phone
(208) 529-2230
Fax
(208) 453-6142
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2103 ID Primary
Physician Assistant 363A00000X PA228669 OR

Addresses

Primary practice location

3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546

Mailing address

PO Box 277381
Atlanta, GA 30384-7381

Other practice location 1

3377 Riverbend Dr
Springfield, OR 97477-8803
Phone (541) 222-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211020002090 ID Practitioner - Physician Assistant 4284022492 Reassigns benefits to 1 organization
I20260128000849 OR Practitioner - Physician Assistant 4284022492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steele Lake Specialty PLLCGroup PAC ID 1153774567, 20 clinicians
PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

3200 Channing Way
Suite A206
Idaho Falls, ID 83404-7586
Phone (208) 529-2230

3377 Riverbend Dr
Springfield, OR 97477-8803
Phone (541) 222-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2103IDMDPhysician Assistant
PA228669ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Surgery CurrentSince Jan 15, 2026 Accepting new patients

Locations

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1740879220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277381",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 206",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-529-2230",
            "fax_number": "208-453-6142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778803",
            "country_code": "US",
            "telephone_number": "541-222-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAHENBUHL",
        "first_name": "KELSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2103",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA228669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.