Lyle Jeremy Jackson, CRNA | |
2325 Coronado St, Idaho Falls, ID 83404-7407 | |
(208) 557-2700 | |
Not Available |
Full Name | Lyle Jeremy Jackson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 24 Years |
Location | 2325 Coronado St, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225597305 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WX0800X | Registered Nurse - Orthopedic | 62439 (Idaho) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | 125895 (Virginia) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Mountain View Hospital | Idaho falls, ID | Hospital |
Idaho Falls Community Hospital, Llc | Idaho falls, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mountain View Hospital Llc | 4486562774 | 188 |
Iceland Anesthesia Management Llc | 7618372996 | 53 |
Entity Name | Madison Anesthesia Services Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558392571 PECOS PAC ID: 9739174152 Enrollment ID: O20040415001317 |
Entity Name | Mountain View Hospital Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
Mailing Address | Practice Location Address |
---|---|
Lyle Jeremy Jackson, CRNA 1090 Barney Dairy Rd, Rexburg, ID 83440-3542 Ph: (801) 319-9345 | Lyle Jeremy Jackson, CRNA 2325 Coronado St, Idaho Falls, ID 83404-7407 Ph: (208) 557-2700 |
Melissa Gallant, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402 Phone: 208-528-5700 Fax: 208-528-5747 | |
Alexis R Siddoway, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-535-4432 | |
Christine Barber, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-604-6605 | |
Jaxon Dean Anderson, CRNA Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 2325 Coronado St, Idaho Falls, ID 83404 Phone: 208-557-2700 | |
James Taylor Barnes, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1415 Whitewater Dr Apt 2104, Idaho Falls, ID 83402 Phone: 801-710-3525 | |
Todd Jensen, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-528-5700 | |
Mrs. Jennifer Sue Karns, FNP Registered Nurse Medicare: Medicare Enrolled Practice Location: 2275 Channing Way, Idaho Falls, ID 83404 Phone: 208-900-3434 |