Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1275261059 Individual Practitioner Female Practitioner

Katie Diane Maddock

Physician Assistant • Idaho Falls, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Katie Maddock is a certified Physician Assistant practicing in Idaho Falls, ID. With approximately 2 years of clinical experience since completing medical education in 2024, Katie Maddock delivers high-quality medical care to the local community at 1550 ELK CREEK DR.

Katie Maddock is affiliated with Leavitt Womens Healthcare Corp.Pc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1550 Elk Creek Dr

Idaho Falls, ID 834048322

Telephone 2085295942
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2024

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Idaho Falls, ID

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
2 Yrs -8.3 yrs vs City Avg
City Avg: 10.3 Yrs
State Avg: 12.4 Yrs
Regional Practice Density
99 Specialists

Practicing in Idaho Falls, ID (1261 Statewide)

Telehealth Adoption Rate
9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Maddock (2 Years) 2 Yrs
Idaho Falls Specialty Average (10.3 Years) 10.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-11-23
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0002896036 (ID)

Hospital & Practice Group Affiliations

Leavitt Womens Healthcare Corp.pc

1550 Elk Creek Dr, Idaho Falls, ID 834048322

Phone: 2085295942

Leavitt Womens Healthcare Corp.pc

1542 Elk Creek Dr, Idaho Falls, ID 834048322

Phone: 2085295942

Leavitt Womens Healthcare Corp.pc

1550 Elk Creek, Idaho Falls, ID 834048322

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Natalie Winegar

Nurse Practitioner - Women's Health

NPI 1063157808
Monica Nealis , PA-C

Physician Assistant

NPI 1073676805

Physician Assistant (Certified)

Mikell Gibbons

Physician Assistant - Medical

NPI 1285563841
Dr. Kayla Asay , MD

Obstetrics & Gynecology

NPI 1346536232

Doctor of Medicine (M.D.)

Dr. Glenn Leavitt , DO

Obstetrics & Gynecology

NPI 1386644318

Doctor of Osteopathic Medicine (D.O.)

Brittany Quinn , WHNP

Nurse Practitioner - Women's Health

NPI 1427514991

Women's Health Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location November 23, 2024

Registered at 1550 ELK CREEK DR, IDAHO FALLS, ID 834048322 (Tel: 2085295942)

📍
Updated Business Mailing Address November 23, 2024

Registered at 1550 ELK CREEK DR, IDAHO FALLS, ID 834048322 (Tel: 2085295942)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 23, 2024

Physician Assistant

NPI Profile Active August 10, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location August 10, 2022

Registered at 921 S 8TH AVE STOP 8253, POCATELLO, ID 832090002 (Tel: 2082824726)

📍
Updated Business Mailing Address August 10, 2022

Registered at 921 S 8TH AVE STOP 8253, POCATELLO, ID 832090002 (Tel: 2082824726)

👤
Provider Name / Credentials Updated August 10, 2022

Recorded as KATIE MADDOCK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration August 10, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275261059
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 10, 2022
Last Update: November 23, 2024
Sole Proprietor: No

Mailing Address

1550 Elk Creek Dr

Idaho Falls, ID 834048322

Phone: 2085295942

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.