NPI age
17 years
Enumerated 2008-10-28
● Active
Type 1 · Individual
Jed Burke Willardson, PA
Willardson is 1 of 105 physician assistant providers in Idaho Falls and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-03-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
17 years
↑ 8 yr above median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-10Enumerated in NPPES
2008
2026
Where they practice
Practice location
2377 Coronado St, Suite C
Idaho Falls, ID 834047440
Mailing address
Po Box 2404
Idaho Falls, ID 834032404
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Practice context
Part of a multi-provider practice. 8 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.