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

Jed Burke Willardson, PA

Individual provider Physician Assistant · NPI 1578716072

Jed Burke Willardson, PA is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2008, 18 years ago. Practices with Mountain View Hospital LLC, a 267-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
18
Licensed in
ID
In the registry since
2008
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

2377 Coronado St Ste C
Idaho Falls, ID 83404-7440
Phone: (208) 523-7246
Fax: (208) 523-7247
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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-779 (ID)

Record details

NPI number1578716072
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 28, 2008
Last updated in NPPESMarch 4, 2009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Mountain View Hospital Llc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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