| 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 | 7 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 |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercyone North Iowa Medical Center | Mason city, IA | Hospital |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| Mercyone Des Moines Medical Center | Des moines, IA | Hospital |
| Idaho Falls Community Hospital, Llc | Idaho falls, ID | Hospital |
| Union Hospital Inc | Terre haute, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Iowa Mercy Clinics | 7810809076 | 307 |
| Cep America - Anesthesia Pc | 3678897915 | 849 |
| Iceland Anesthesia Management Llc | 7618372996 | 70 |
| Mountain View Hospital Llc | 4486562774 | 265 |
| Entity Name | North Iowa Mercy Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780278242 PECOS PAC ID: 7810809076 Enrollment ID: O20031105000273 |
| 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 | |
Amanda Nichole Cook, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3547 E Beretta Ave, Idaho Falls, ID 83401 Phone: 208-206-9549 | |
Alexis R Siddoway, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-535-4432 | |
Chantel Nmn Mower, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 675 E Anderson St, Idaho Falls, ID 83401 Phone: 986-497-9305 | |
Mrs. Jessica Munson Steiner, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 675 E Anderson St, Idaho Falls, ID 83401 Phone: 208-432-1976 Fax: 208-278-7956 | |
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 |