NPI age
19 years
Enumerated 2006-08-09
● Active
Type 1 · Individual
Charles A Jacobson, M.D.
Jacobson is 1 of 7 orthopaedic surgery providers in Moscow and 1 of 239 in Idaho.
Primary specialty
Orthopaedic Surgery
Plus 1 subspecialty
Licensed in
ID, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2015-08-04
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 239 active orthopaedic surgery providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 74% — 25% of peers are multi-state
Subspecialties
0
45% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
2500 W A St, Suite 201
Moscow, ID 838435065
Mailing address
2500 W A St, Suite 201
Moscow, ID 838435065
Specialties
-
Orthopaedic Surgery PrimaryAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 0102784 | DEPT OF LABOR |
| 05 (ID) | 002743901 | |
| 05 (WA) | 1092733 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 6 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 →
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