Jedidiah Dykstra

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2596 N Stokesberry PL Ste 180
Meridian, ID 83646-6282

Phone

(208) 590-5739

NPI assigned

Feb 24, 2017

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Heart at Peace Counseling PLLC

  • Marriage & Family Therapist
  • Meridian, ID
  • NPI 1205603669
  NPD Authorized official
• Easterseals-Goodwill Northern Rocky Mountain, Inc

  • Community/Behavioral Health Agency
  • Caldwell, ID
  • NPI 1558706945
  NPD (past)

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1972043966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2596 N STOKESBERRY PL STE 180",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466282",
            "telephone_number": "208-590-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2596 N STOKESBERRY PL STE 180",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466282",
            "telephone_number": "208-590-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "JEDIDIAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Duskey
• Maxwell Aristaeus Dusky, LPC
• Shane Michael Duty, LPC
• Lauren Dye
• Hannah Dyer, APRN
• Dynamed Inc
• E Z Transport LLC
• Eagle Anesthesia LLC
• Eagle Eye Surgery and Laser Center LLC
• Eagle Health Services LLC

• All providers in Meridian, ID
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.