Kyle Phillip Dietrich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7381730 Issued in ID

Practice address

2177 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639

Phone

(208) 625-6111

Fax

(208) 625-6112

NPI assigned

Apr 3, 2019

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1932661352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-6111",
            "fax_number": "208-625-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-6111",
            "fax_number": "208-625-6112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 S 8th Ave Stop 8253",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832090002",
            "country_code": "US",
            "telephone_number": "208-282-4726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "KYLE",
        "middle_name": "PHILLIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "7381730",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "LMT-LMT-LIC-15881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angeli Di Lucca
• Salvatore Di Raffaele, PA-C, D.C.
• Linda J Diamond, DIETITIAN
• Delwyn Lee Dick, D.D.S.
• Chelsea Dickman, PA-C
• Sadie Dignan
• Penelope Dill, LMFT
• Grace Traal Dillman, CNA
• Rebecca Dillman
• Macy Dimler

• Physician Assistant in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.