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

Jacob Sup, DO

Individual provider Family Medicine Physician · NPI 1295266401

Jacob Sup, DO is a Family Practice in Caldwell, Idaho. Graduated from At Still Un of Hlth Sciences, Col of Osteo Med, Mesa in 2017, 9 years ago. Practices with Community Health Clinics Inc, a 74-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Trained at
At Still Un of Hlth Sciences, Col of Osteo Med, Mesa
Licensed in
ID
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2005 Arlington Ave
Caldwell, ID 83605-4808
Phone: (208) 459-1025
Fax: (208) 459-1080
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-1402 (ID)

Record details

NPI number1295266401
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 21, 2017
Last updated in NPPESAugust 7, 2020
Certification dateAugust 7, 2020
Mailing addressPo Box 9, Nampa, ID 83653-0009

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UN OF HLTH SCIENCES, COL OF OSTEO MED, MESA
Graduated 2017 (9 years in practice)
Group practice Community Health Clinics Inc — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Caldwell