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

Jaclyn Johnson Jolley, PA

Individual provider Physician Assistant · NPI 1184144305

Jaclyn Johnson Jolley, PA is a Physician Assistant in Twin Falls, Idaho. Qualified in 2017, 9 years ago. Practices with St Lukes Clinic LLC, a 310-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

775 Pole Line Rd W Ste 312
Twin Falls, ID 83301-5823
Phone: (208) 814-8500
Fax: (208) 814-8960
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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 PA-1520 (ID)

Record details

NPI number1184144305
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 20, 2017
Last updated in NPPESJune 10, 2024
Certification dateJune 10, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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