Lyle Jeremy Jackson, CRNA

Primary specialty

Orthopedic Registered NurseTaxonomy code 163WX0800X

License

62439 Issued in ID

Practice address

2325 Coronado St
Idaho Falls, ID 83404-7407

Phone

(208) 557-2700

NPI assigned

Mar 18, 2019

Last updated

Jun 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, IN, IA3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone North Iowa Medical Center Hospital, Mason City, IA, CCN 160064
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
• Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • West Des Moines, IA
  • NPI 1194516146

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Iceland Anesthesia Management, LLC

  • Anesthesiology Physician
  • Terre Haute, IN
  • NPI 1912578667

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• North Iowa Mercy Clinics

  dba MercyOne North Iowa Anesthesia Professional Services

  • Anesthesiology Physician
  • Mason City, IA
  • NPI 1780278242

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment Care Compare group
• Clinical Colleagues LLC

  • Anesthesiology Physician
  • Van Wert, OH
  • NPI 1992725766

  IN, Multi-Specialty

  Medicare reassignment NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Des Moines, IA
  • NPI 1023809076

  Multi-Specialty

  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Langhorne, PA
  • NPI 1093678229

  Multi-Specialty

  NPD
• North Iowa Mercy Clinics

  dba MercyOne North Iowa Family and Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Mason City, IA
  • NPI 1982300349

  Multi-Specialty

  NPD

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

• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Catholic Health Initiatives - Iowa Corp

  dba MercyOne West Des Moines Medical Center

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1538395975
  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  dba MercyOne Des Moines Laboratory

  • Clinical Medical Laboratory
  • Des Moines, IA
  • NPI 1104982743

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  dba MercyOne Des Moines Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883
  Care Compare affiliation
• Catholic Health Initiatives, Ia-Corp

  dba Mercy Medical Mammography Center

  • Mammography Clinic/Center
  • Des Moines, IA
  • NPI 1477984367

  Hospital

  Care Compare affiliation
• Mercy Health Services-Iowa Corp

  dba Mercy Medical Center-North Iowa

  • Rural Acute Care Hospital
  • Mason City, IA
  • NPI 1467537886
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1225597305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 BARNEY DAIRY RD",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403542",
            "telephone_number": "801-319-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-557-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LYLE",
        "middle_name": "JEREMY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "125895",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D183481",
            "primary": false
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "ID",
            "license": "62439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J&V Services, Inc. (Thrive Integrative Counseling)
• Alyssa May Jack, PA-C
• Dallin Jackman
• Beverly Joanne Jackson
• Kenneth William Jackson, PA
• Brandon Thomas Jacobson, DMD
• Brett Dean Jacobson, DDS
• Lance Glen Jacobson, MD
• Jennifer Jahn
• Bradley James

• Registered Nurse in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.