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

Johnathon Chase Wilde, PA-C

Individual provider Physician Assistant · NPI 1073231999

Johnathon Chase Wilde, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2024, 2 years ago. Practices with Family First Medical Center PLLC, an 18-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2022
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

3820 Crestwood Ln
Idaho Falls, ID 83404-4979
Phone: (208) 552-7700
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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 8361377 (ID)

Record details

NPI number1073231999
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 16, 2022
Last updated in NPPESSeptember 26, 2024
Certification dateSeptember 26, 2024

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 Family First Medical Center Pllc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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