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Provider Profile

Kenneth W. Jackson, PA

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At a glance

About Kenneth Jackson

Kenneth W. Jackson, PA is a physician assistant practicing in Idaho Falls, ID. This provider record is associated with NPI 1194587824.

Factual summary compiled by Guide.md from public records; not written by this provider.

Education & Training

School Other Graduated: 2024

Specialty

Credentials & Licensing

ID licenceAs reported to the NPI registry
No. 7871497As reported
KY licenceAs reported to the NPI registry
No. TC075As reported
NPINational Provider Identifier
1194587824Issued 2024

As reported to the NPI registry ↗

Medicare information

Accepts Medicare assignmentYes
Medicare opt-outNo
Can order and refer in MedicareYes

Exactly as CMS reports it (National Downloadable File, Opt-Out Affidavits, Order & Referring). Not an insurance directory; confirm coverage with the office.

Common questions

What does Kenneth W. Jackson specialize in?

Kenneth W. Jackson is a physician assistant in Idaho Falls, ID. That is the designation recorded for this NPI in the federal registry.

NPI registry

Where is Kenneth W. Jackson located?

Kenneth W. Jackson is listed at 3200 Channing Way Ste A206, Idaho Falls, ID 83404. Addresses come from the NPI registry and can lag a move, so confirm before travelling.

NPI registry

What is Kenneth W. Jackson's phone number?

The number on file is (208) 529-2230. Contact the office directly to confirm availability and scheduling.

NPI registry

What is Kenneth W. Jackson's NPI number?

Kenneth W. Jackson's National Provider Identifier is 1194587824. It is issued by the Centers for Medicare & Medicaid Services and is unique and permanent — it does not change if they move practice.

NPI registry

Where did Kenneth W. Jackson train?

Kenneth W. Jackson attended Other, graduating in 2024. This comes from the CMS National Downloadable File.

CMS public data

How long has Kenneth W. Jackson been practicing?

Kenneth W. Jackson has 2 years experience. Calculated from a graduation year of 2024, reported in the CMS National Downloadable File.

CMS public data

Has Kenneth W. Jackson confirmed this information?

Not yet. This profile is built from public federal data and has not been confirmed by Kenneth W. Jackson. If this is you, claiming it is free.

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