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

Kovic Shane Bailey, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1194467688

Kovic Shane Bailey, DO is a Family Practice in Twin Falls, Idaho. Qualified in 2022, 4 years ago. Practices with St Lukes Clinic LLC, a 310-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Texas.

Years since qualifying
4
Licensed in
ID, TX
In the registry since
2022
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.

See every abbreviation used in this directory →

Practice location Address checks out

775 Pole Line Rd W
Twin Falls, ID 83301-5814
Phone: (208) 814-8000
Fax: (208) 733-9402
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11937 Us Highway 271, Tyler, TX 75708-3154 — (903) 877-7777

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 7771540 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence BP10080618 (TX)

Record details

NPI number1194467688
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 13, 2022
Last updated in NPPESJune 27, 2025
Certification dateJune 27, 2025
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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