Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaceson Banham, PA-C

Individual provider Physician Assistant · NPI 1295544344

Jaceson Banham, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2024, 2 years ago. Practices with Mountain View Hospital LLC, a 267-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1957 E 17th St
Idaho Falls, ID 83404-6429
Phone: (208) 523-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8671842 (ID)

Record details

NPI number1295544344
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 3, 2025
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mountain View Hospital Llc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Idaho Falls