Jacob Craig Stoddard, APRN-CNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5381502 Issued in ID

Practice address

2455 Blue Camas Way
Idaho Falls, ID 83402-3849

Phone

(208) 242-8036

NPI assigned

Apr 4, 2026

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1775260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775260800000",
    "number": "1174464929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 BLUE CAMAS WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023849",
            "telephone_number": "208-242-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 BLUE CAMAS WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023849",
            "telephone_number": "208-242-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "JACOB",
        "middle_name": "CRAIG",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-04",
        "last_updated": "2026-04-04",
        "certification_date": "2026-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "5381502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey B Stieglitz, MD
• Kassandra Noelle Stine, PTA
• Carmen Stites
• Raini Nichole Stock, LCPC
• Rod T. Stocking, D.C.
• Jordan Stoddard, DPT
• Hayley Stoddart, BS
• Tanner Nathan Stohl
• Richard D Stoker, D.M.D.
• Zachary Blake Stoker

• Primary Care Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.