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

Kody Ray Gould, PA

Individual provider Physician Assistant · NPI 1750046983

Kody Ray Gould, PA is a Physician Assistant in Blackfoot, Idaho. Qualified in 2021, 5 years ago. Practices with Bmh Inc, a 136-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1350 Parkway Dr
Blackfoot, ID 83221-1657
Phone: (208) 782-2410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2158 (ID)

Record details

NPI number1750046983
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 2, 2021
Last updated in NPPESNovember 2, 2021
Certification dateNovember 2, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Bmh Inc — 136 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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