Individual provider Active NPI

Jaden Juergens, PA-C

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1538810577
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12637509-1206 Issued in UT
Practice address
201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692
Phone
(801) 543-5875
NPI assigned
Jan 11, 2022
Last updated
May 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2272 ID
Physician Assistant 363A00000X 12637509-1206 UT Primary

Addresses

Primary practice location

201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

2730 Channing Way
Idaho Falls, ID 83404-5049
Phone (208) 542-7100

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221114003184 ID Practitioner - Physician Assistant 9133597644 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians
Community Care West Side LLCGroup PAC ID 3678738218, 17 clinicians

Practice addresses (Care Compare)

2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310

2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823

2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2730 Channing Way
Idaho Falls, ID 83404-5049
Phone (208) 542-7100

765 S Utah Ave
Idaho Falls, ID 83402-5093
Phone (208) 585-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2272IDMDPhysician Assistant
12637509-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Pocatello PLLC Current Accepting new patients
Mountain View Hospital LLC CurrentSince Oct 19, 2022 Accepting new patients
Community Care Current Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1538810577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LAYTON PKWY STE 1A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413692",
            "telephone_number": "801-543-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 Channing Way",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834045049",
            "country_code": "US",
            "telephone_number": "208-542-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUERGENS",
        "first_name": "JADEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2272",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12637509-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.