Jacob Wayda

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

76016 Issued in ID

Practice address

1900 W Chinden Blvd
Meridian, ID 83646-6690

Phone

(208) 809-2860

Fax

(208) 809-2861

NPI assigned

Jan 17, 2024

Last updated

Mar 20, 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 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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.wayda@phmg.eclinicaldirectplus.com

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.

• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203

  Multi-Specialty

  NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Meridian, ID
  • NPI 1386003770

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1801657713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W CHINDEN BLVD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466690",
            "telephone_number": "208-809-2860",
            "fax_number": "208-809-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYDA",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "76016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Watson, PA-C
• Cyrilla Watson, RBT
• Kimberly Watson, NP
• Mia Watson
• Michael A Watts, MD
• Waypoint Therapy
• We Are Better Together, LLC
• Kathy Weathers, LMT
• Samuel Weatherspoon
• Melissa Weaver

• Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.