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

Lyle Jeremy Jackson, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1225597305

Lyle Jeremy Jackson, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Idaho Falls, Idaho. Qualified in 2019, 7 years ago. Practices with North Iowa Mercy Clinics, a 300-clinician group and accepts Medicare assignment. Licensed in Iowa, Idaho and Virginia.

Years since qualifying
7
Licensed in
IA, ID, VA
In the registry since
2019
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone: (208) 557-2700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Registered Nurse (primary) Taxonomy 163WX0800X · Licence 62439 (ID)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 125895 (VA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence D183481 (IA)

Record details

NPI number1225597305
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedMarch 18, 2019
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice North Iowa Mercy Clinics — 300 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Idaho Falls