JACE KELLER WHITE – Family Nurse Practitioner, NPI 1861371171

JACE KELLER WHITE is a healthcare provider. based in Shelley, Idaho. specializing in NURSE PRACTITIONER. They hold a License No. 8671480 (ID). The NPI Number for JACE KELLER WHITE is 1861371171

Main info

Organization
1 Year Of Experience
Accepts Medicare Assignment
Name
JACE KELLER WHITE
NPI
1861371171
Phone
(208) 932-5106
Address
251 BRENT WAY
Enumeration Date
29 August 2025
Last Update Date
12 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082527654
Graduation Year
2025 (1 year ago)
PAC ID
2365928918
Group Practice PAC ID
7810807427
Professional Enrollment ID
I20260113003080
Address ID
ID832135003AR551XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

1,802 NURSE PRACTITIONER in ID

Provider Addresses for JACE KELLER WHITE

  • 251 BRENT WAY

    SHELLEY, ID 832741203

    Phone: (208) 932-5106

    Type: Mailing

  • 551 HIGHLAND DR

    ARCO, ID 832135003

    Phone: (208) 252-7654

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260113003080INurse PractitionerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83274)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810807427View full group profile
NameSpecialtyState
Family PracticeID
Nurse PractitionerID
Cardiovascular Disease (Cardiology), General PracticeID
P O D I A T R YID
Nurse PractitionerID
Nurse PractitionerID
-WA
Nurse PractitionerNM

Reviews

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Frequently asked questions

What federal number belongs to JACE KELLER WHITE?
The federal identifier for JACE KELLER WHITE is NPI 1861371171.
Does this profile mean JACE KELLER WHITE is currently active?
Yes — JACE KELLER WHITE appears active in the national provider directory.
What does JACE KELLER WHITE treat or focus on?
Patients typically see JACE KELLER WHITE under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is JACE KELLER WHITE's primary listing?
We display Shelley, Idaho because that is what the record indicates for JACE KELLER WHITE.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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