Jed Willardson (NPI# 1578716072, PAC ID# 5698964401) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1578716072 |
| PAC ID by PECOS | 5698964401 |
| Professional Enrollment ID | I20110110000839 |
| Full Name | Jed Willardson |
| Organization Legal Name | MOUNTAIN VIEW HOSPITAL LLC |
| Address |
1425 Pkwy Dr Blackfoot ID 83221-1667 |
| Phone Number | 2087857246 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4486562774 |
| Number of Group Practice Members | 111 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130065 | MOUNTAIN VIEW HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1425 Pkwy Dr, Blackfoot, ID 83221-1667 | 2087857246 | MOUNTAIN VIEW HOSPITAL LLC |
| 1441 Pkwy Dr, Blackfoot, ID 83221-1667 | 2087852600 | MOUNTAIN VIEW HOSPITAL LLC |
| 2325 Coronado St, Idaho Falls, ID 83404-7407 | 2085572700 | MOUNTAIN VIEW HOSPITAL LLC |
| 2330 Coronado St, Idaho Falls, ID 83404-7407 | 2085521234 | MOUNTAIN VIEW HOSPITAL LLC |
| 2353 Coronado St, Idaho Falls, ID 83404-7407 | 2085524823 | MOUNTAIN VIEW HOSPITAL LLC |
| 3385 Potomac Way, Idaho Falls, ID 83404-4978 | 2085227246 | MOUNTAIN VIEW HOSPITAL LLC |
| Organization Legal Name | MOUNTAIN VIEW HOSPITAL LLC |
| Physicians | 106 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tina Scoggins | Osteopathic Manipulative Medicine | Mountain View Hospital LLC | 2725 Channing Way, Idaho Falls, ID 83404-7510 |
| Richard Willis Runyan | Pain Management | Mountain View Hospital LLC | 3385 Potomac Way, Idaho Falls, ID 83404-4978 |
| Andrew D Cooper | Physical Medicine and Rehabilitation | Mountain View Hospital LLC | 3614 Washington Pkwy, Idaho Falls, ID 83404-7573 |
| Amanda N Thompson | Nurse Practitioner | Mountain View Hospital LLC | 2680 Channing Way, Idaho Falls, ID 83404-7517 |
| Stephanie L Sander | Physician Assistant | Mountain View Hospital LLC | 1550 Hoopes Ave, Idaho Falls, ID 83404-5799 |
| Matthew Ivie | Physician Assistant | Mountain View Hospital LLC | 2325 Coronado St, Idaho Falls, ID 83404-7407 |
| Daric J Russell | Pain Management | Mountain View Hospital LLC | 1425 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Patricia Stadler | Nurse Practitioner | Mountain View Hospital LLC | 167 E 1st, Rigby, ID 83442-1401 |
| Bryce Campbell | Nurse Practitioner | Mountain View Hospital LLC | 2730 Channing Way, Idaho Falls, ID 83404-5049 |
| Timothy E Snell | Interventional Pain Management | Mountain View Hospital LLC | 1950 E Clark St, Suite 110, Pocatello, ID 83201-3315 |
| Street Address |
1425 PKWY DR |
| City | BLACKFOOT |
| State | ID |
| Zip | 83221-1667 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daric J Russell | Pain Management | Mountain View Hospital LLC | 1425 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Christy Taylor | Nurse Practitioner | Mountain View Hospital LLC | 1425 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan T Sayre | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Mark L Edlefsen | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Brandon K Pieper | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Zachary D Morrow | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Cory J Sayre | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Shawn M Murray | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Christopher L Wehrli | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Shawn A Wren | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Dee S Stevens | Chiropractic | 725 Jensen Grove Dr, Suite 4, Blackfoot, ID 83221-1636 | |
| Anne M Preston | Clinical Social Worker | Portneuf Valley Family Center, Inc. | 1495 Pkwy Dr C, Blackfoot, ID 83221-1639 |
| Find all physicians in zip 83221 | |||
| City | BLACKFOOT |
| Zip Code | 83221 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BLACKFOOT + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jed Willardson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.