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

Mr. Jacob Wayne Moss, MD, JD

Individual provider General Practice Physician · NPI 1205179751

Mr. Jacob Wayne Moss, MD, JD is a General Practice in Saint Anthony, Idaho. Graduated from Southern Illinois University School of Medicine in 2013, 13 years ago. Practices with Teton Valley Health Care Inc, a 33-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia and Idaho.

Years since qualifying
13
Trained at
Southern Illinois University School of Medicine
Licensed in
GA, ID
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

335 E Main St Ste 1
Saint Anthony, ID 83445-1546
Phone: (208) 356-4900
Fax: (208) 624-4116
Show map & directions

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

Additional practice locations (2)

  • 3724 Woodking Dr Ste 1, Idaho Falls, ID 83404 — (208) 356-4900
  • 72 S 1st E Ste 101, Rexburg, ID 83440-1902 — (208) 356-4900

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence M-14547 (ID)
General Practice Physician Taxonomy 208D00000X · Licence TM190 (GA)

Record details

NPI number1205179751
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , JD
Sole proprietorNo
NPI enumeratedApril 3, 2013
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025
Mailing addressPo Box 18, Saint Anthony, ID 83445-0018

Medicare enrollment

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

Medicare specialtyGENERAL PRACTICE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Teton Valley Health Care Inc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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