NPI age
19 years
Enumerated 2006-10-23
● Active
Type 1 · Individual
Glenn E Jefferson JR., MD
Jefferson is 1 of 23 family medicine providers in Lewiston and 1 of 1691 in Idaho.
Primary specialty
Family Medicine
Plus 1 subspecialty
Licensed in
ID, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2016-03-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1691 active family medicine providers in Idaho.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
2 states
Top 85% — 14% of peers are multi-state
Subspecialties
0
31% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Practice location
2315 8th St
Lewiston, ID 835017301
Mailing address
2315 8th St
Lewiston, ID 835017301
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 31254 | LABOR & INDUSTRIES |
| 01 (ID) | 1326121286 | HEALTHY CONNECTIONS |
| 01 (ID) | 1326121286 | REGENCE BLUESHIELD OF IDAHO |
| 05 (WA) | 1007806 | |
| 05 (ID) | 1326121286 | |
| 01 (ID) | 80094289 | RAILROAD MEDICARE |
| 01 (ID) | DF540 | BLUE CROSS |
| 01 (ID) | 1119637 | DMERC |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 56 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.
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