JARED KENT WILSON (NPI# 1275748089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275748089 |
| Entity Type | Individual |
| Full Name | JARED KENT WILSON |
| Credential | PA-C, MPAS, MED, ATC |
| Practice Address |
777 Hospital Way Building A, Suite 201 Pocatello ID 83201-5175 |
| Mailing Address |
1018 Linda Pl Pocatello ID 83201-3058 |
| Practice Telephone | 2082392714 |
| Mailing Telephone | 2082200232 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-12-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
0126001086 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922350321 | Jared Lane Wilson | Chiropractor | 8611 N Division St Ste A, Spokane, WA 99208-5946 | 2012-10-09 |
| 1104059104 | Jared Wilson | Chiropractor | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2009-08-25 |
| 1699868927 | Jared Paul Wilson | Physician Assistant | 7070 E Drive North, Battle Creek, MI 49014-8562 | 2006-09-30 |
| 1902876667 | Jared K Wilson | Family Medicine | 112 Liberty Sq, Liberty, KY 42539-3392 | 2006-01-25 |
| 1922532977 | Jared Wilson | Internal Medicine | 1501 N Campbell Ave, Room 6336, Tucson, AZ 85724-5040 | 2017-04-17 |
| 1639461304 | Jared Michael Wilson | Anesthesiology | 77 Nealy Ave, Langley Afb Hospital - Anesthesiology Dept, Langley Afb, VA 23665-2040 | 2011-05-12 |
| 1598998353 | Jared A Wilson | Physician Assistant | 1662 Higdon Ferry Road, Ste 300, Hot Springs, AR 71913 | 2009-08-27 |
| Street Address |
777 HOSPITAL WAY BUILDING A, SUITE 201 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1437612447 | Walter S Medlin Md PC | Surgery | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-04-08 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962832923 | Dale Mckay Belnap | Physician Assistant | 444 Hospital Way Ste 710, Pocatello, ID 83201-2745 | 2013-11-12 |
| 1659689362 | Steven L Nelson | Physician Assistant | 560 Memorial Dr, Pocatello, ID 83201-4073 | 2010-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218089 | Michael Keegan Huntsman | Physician Assistant | 730 Aspen Ave, Shelley, ID 83274-1400 | 2020-06-03 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1831647197 | Nicholas Hensley | Physician Assistant | 3155 Channing Way Ste B, Idaho Falls, ID 83404-7534 | 2016-09-15 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1982937066 | Don H Curtis | Physician Assistant | 348 W Bloomington Dr, Meridian, ID 83642-6942 | 2009-09-08 |
| 1801073655 | Tracy D. Mickelsen | Physician Assistant | 3015 E Magic View Dr, Meridian, ID 83642-3743 | 2008-01-23 |
| 1356437172 | Clare Elizabeth York | Physician Assistant | 805 Main St., Salmon, ID 83467 | 2006-10-05 |
| 1891707618 | Brian Keith Lachapelle | Physician Assistant | 6140 W Curtisan, Ste 102, Boise, ID 83704 | 2006-08-12 |
| 1992743215 | Bill Stahlberg | Physician Assistant | 211 Forest St, Mccall, ID 83638-5256 | 2006-06-02 |
| 1780641530 | Alicia R Borst | Physician Assistant | 3960 W. Wainwright, Boise, ID 83713 | 2006-04-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.