P Praxis·MD
● Active Type 1 · Individual

Janiel J Green, PA-C

Physician Assistant·Rexburg, ID· NPI 1114297660 · Enumerated 2011 · 14 years on NPI
Green is 1 of 11 physician assistant providers in Rexburg and 1 of 387 in Idaho.
NPI age
14 years
Enumerated 2011-12-30
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2011-12-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 387 active physician assistant providers in Idaho.

NPI age
14 years
≈ at median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties

NPI lifetime · 2011 → 2026

2011-12Enumerated in NPPES
2011 2026

Where they practice

Practice location
36 Professional Plz, Suite #102
Rexburg, ID 834402049
📞 2083560234fax 2086568444
Mailing address
36 Professional Plz, Suite #102
Rexburg, ID 834402049
📞 2083560234fax 2086568444

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #PA-957 taxonomy 363AM0700X

Practice context

Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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