NPI age
19 years
Enumerated 2007-05-14
● Active
Type 1 · Individual
Jared Kent Wilson, PA-C, MPAS, MED, ATC
Wilson is 1 of 8 physician assistant providers in Pocatello and 1 of 97 in Idaho.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-08-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 97 active physician assistant providers in Idaho.
NPI age
19 years
↑ 6 yr above median (13 yr)
State licenses
1 state
23% of peers hold multiple states
Subspecialties
1
In the 56% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Practice location
777 Hospital Way, South Mob, Suite 204
Pocatello, ID 832015175
Mailing address
777 Hospital Way, South Mob, Suite 204
Pocatello, ID 832015175
Specialties
-
Physician Assistant PrimaryDefinition to come...
-
Specialist/TechnologistAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently,...
Practice context
Part of a multi-provider practice. 144 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.