Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly L Dustin, DO

Individual provider Family Medicine Physician · NPI 1114957362

Kelly L Dustin, DO is a Family Practice in Rexburg, Idaho. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2006, 20 years ago. Practices with Fall River Medical PLLC, an 8-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
20
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
ID
In the registry since
2006
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

21 Winn Dr
Rexburg, ID 83440-5277
Phone: (208) 881-5222
Fax: (877) 441-4715
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-0459 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence MR0875 (ID)

Record details

NPI number1114957362
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 4, 2006
Last updated in NPPESNovember 19, 2019
Mailing address794 Eastland Dr, Twin Falls, ID 83301-6856

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2006 (20 years in practice)
Group practice Fall River Medical Pllc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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