Individual provider Active NPI

Jacob Allen Dyreng, HIS

  • Hearing Instrument Specialist
  • Fruitland, ID
National Provider Identifier
1003713041
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1781338 Issued in ID
Practice address
1407 N Whitley Dr
Fruitland, ID 83619-2242
Phone
(208) 739-4839
NPI assigned
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1781338 ID Primary

Addresses

Primary practice location

1407 N Whitley Dr
Fruitland, ID 83619-2242

Mailing address

1407 N Whitley Dr
Fruitland, ID 83619-2242
Phone (208) 739-4839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1792627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1003713041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192242",
            "telephone_number": "208-739-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192242",
            "telephone_number": "208-739-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYRENG",
        "first_name": "JACOB",
        "middle_name": "ALLEN",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "ID",
            "license": "1781338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.