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

Ryan Blair Killpack, PA-C

Individual provider Surgical Physician Assistant · NPI 1114405396

Ryan Blair Killpack, PA-C is a Physician Assistant in Blackfoot, Idaho. Qualified in 2018, 8 years ago. Practices with Bmh Inc, a 136-clinician group and accepts Medicare assignment.

Years since qualifying
8
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

98 Poplar St
Blackfoot, ID 83221-1758
Phone: (208) 785-4100
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1114405396
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 31, 2018
Last updated in NPPESJuly 31, 2018
Mailing address98 Poplar St, Blackfoot, ID 83221-1758

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Bmh Inc — 136 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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