Kebai Dawn Bills, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

520 Issued in ID

Practice address

1777 E. Clark Suite # 210
Pocatello, ID 83201

Phone

(208) 233-5433

Fax

(877) 284-2783

NPI assigned

Mar 29, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kebai Dawn Gamblin Former name

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Life Change Associates PCGroup PAC ID 8224265574, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Life Change Associates, PC

  • Psychiatry Physician
  • Pocatello, ID
  • NPI 1598077562
  Medicare reassignment Care Compare group
• Horizon Mental Health Management, Inc

  dba Horizon Mental Health

  • Psychiatry Physician
  • Lewisville, TX
  • NPI 1962452060
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1750342952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E. CLARK, SUITE # 210",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 E. CLARK SUITE # 210",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLS",
        "first_name": "KEBAI",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA520",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICEN",
            "identifier": "PA 520",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEBAI",
            "last_name": "GAMBLIN",
            "middle_name": "DAWN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Big Steps Speech Therapy, LLC
• Sara Anne Bigelow, LCPC
• Bilingual Psychological and Educational Assessment Specialists PLLC (Bpeaspllc)
• Cassandra R Bills, LCPC
• David Bills, LPC, NCC
• Sandra Bills, M.A.ED., LCPC
• Nicole Grace Binggeli
• Baylee Biorn
• Chloe Burton Birchfield, DMD
• Megan Olsen Bird, PH.D.

• Medical Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.