Flint Dean Jacobson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

73078 Issued in ID

Practice address

166 S 5TH St
Montpelier, ID 83254-4959

Phone

(208) 847-3847

NPI assigned

Aug 18, 2022

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, UT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: fjacobson620119@direct.ochin.org

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.

• Bear Lake County Memorial Hospital

  • Internal Medicine Physician
  • Montpelier, ID
  • NPI 1174741441

  ID

  Medicare reassignment Care Compare group
• Bear Lake County Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Garden City, UT
  • NPI 1538916333

  UT

  Medicare reassignment Care Compare group
• Bear Lake County Memorial Hospital

  • Critical Access Hospital
  • Montpelier, ID
  • NPI 1336125533
  Care Compare group
• Bear Lake County Memorial Hospital

  • Skilled Nursing Facility
  • Montpelier, ID
  • NPI 1568552446
  Care Compare group
• Bear Lake County Memorial Hospital

  • Skilled Nursing Facility
  • Montpelier, ID
  • NPI 1659461531
  Care Compare group
• Bear Lake County Memorial Hospital

  • Home Health Agency
  • Montpelier, ID
  • NPI 1669521084
  Care Compare group
• Bear Lake County Memorial Hospital

  • Rural Health Clinic/Center
  • Montpelier, ID
  • NPI 1699057166
  Care Compare group
• Bear Lake County Memorial Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Montpelier, ID
  • NPI 1740370626
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bear Lake County Memorial Hospital

  • Critical Access Hospital
  • Montpelier, ID
  • NPI 1336125533

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bear Lake County Memorial Hospital 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bear Lake Memorial Hospital Hospital, Montpelier, ID, CCN 131316

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1033837893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 S 5TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832544959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 S 5TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832544959",
            "telephone_number": "208-847-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "FLINT",
        "middle_name": "DEAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "73078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health West, Inc.
• Brandon J. Henscheid, PSY.D.
• Casey Humpherys
• Ory Brad Hutchison, PHARMD
• Gregory William Hyde, DPT
• Trevor Dean Jacobson, M.D.
• Marilee Johnson, MRC, LPC
• Joseph F Decker Professional Corp
• Josh Bowman DC PLLC
• Angela K Kelly, LCSW

• All providers in Montpelier, ID
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.