P Praxis·MD
● Active Type 1 · Individual

Derrick Ray Jorgensen

Physician Assistant·Idaho Falls, ID· NPI 1609519198 · Enumerated 2022 · 4 years on NPI
Jorgensen is 1 of 105 physician assistant providers in Idaho Falls and 1 of 1263 in Idaho.
NPI age
4 years
Enumerated 2022-04-14
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2026-01-28
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
4 years
↓ 5 yr below median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties

NPI lifetime · 2022 → 2026

2022-04Enumerated in NPPES
2022 2026

Where they practice

Practice location
3200 Channing Way Ste 206
Idaho Falls, ID 834047546
📞 2085292230fax 2085618061
Mailing address
3200 Channing Way Ste 206
Idaho Falls, ID 834047546
📞 2087165614

Specialties

  • Physician Assistant Primary
    A 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...
    ID license #PA-2250 taxonomy 363A00000X

Practice context

Part of a multi-provider practice. 15 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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