Jacob Craig Stoddard, APRN-CNP
NPI 1174464929ActiveIndividual· Nurse Practitioner, Primary Care· Idaho Falls, ID
Nurse Practitioner, Primary Care (APRN-CNP) with Community Care West Side LLC, practicing in Idaho Falls, Idaho. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1174464929 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APRN-CNP |
| Sole proprietor | Yes |
| NPI issued | Apr 4, 2026 |
| Last updated in NPPES | Apr 4, 2026 |
| Certified by provider | Apr 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | 5381502 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (ID) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Community Care West Side LLCIdaho Falls, ID · 17 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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