Jacob Walker, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-1452 Issued in ID

Practice address

382 N Overland Ave
Burley, ID 83318-3433

Phone

(208) 678-6996

Fax

(208) 678-6866

NPI assigned

Nov 9, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care of Idaho LLCGroup PAC ID 8527381136, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Urgent Care of Idaho, LLC

  • Urgent Care Clinic/Center
  • Jerome, ID
  • NPI 1538578687
  Medicare reassignment Care Compare group NPD
• River View Urgent Care & Medical Center Inc

  • Urgent Care Clinic/Center
  • Burley, ID
  • NPI 1790043693
  Medicare reassignment
• Urgent Care of Idaho, LLC

  • Urgent Care Clinic/Center
  • Burley, ID
  • NPI 1841972122
  NPD

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1033651989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 MONROE ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013857",
            "telephone_number": "208-404-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 N OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183433",
            "telephone_number": "208-678-6996",
            "fax_number": "208-678-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urgent Care of Idaho, LLC
• Valley True Health LLC
• Victoria Vasquez Davila, NCMA
• Wal-Mart Stores, Inc
• Walgreen Co
• Walmart Inc.
• Walter M. Graham, M.D.
• Bethany Walton, OTR/L
• Justin Ward, D.M.D.
• Laura Watkins, RD

• Medical Physician Assistant in Burley, ID
• Providers in Burley, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.