Kenneth William Jackson, PA
NPI 1194587824ActiveIndividual· Physician Assistant· Idaho Falls, ID
Physician Assistant (PA) with Baptist Health Medical Group Inc and 1 other group, practicing in Idaho Falls, Idaho. Medicare paid $1,203 for services to 12 patients in 2024. Lists Baptist Health Corbin as a hospital affiliation.
Overview
| NPI | 1194587824 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | Yes |
| NPI issued | Jan 29, 2024 |
| Last updated in NPPES | Jun 9, 2026 |
| Certified by provider | Jun 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 7871497 | ID |
| Physician Assistant | 363A00000X | TC075 | KY |
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 - Physician Assistant (ID); Practitioner - Physician Assistant (KY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 12 |
|---|---|
| Services billed | 12 across 3 procedure codes |
| Paid by Medicare | $1,203 |
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Baptist Health Medical Group IncMadison, IN · 2,472 clinicians
- Steele Lake Specialty PLLCIdaho Falls, ID · 20 clinicians
Hospital affiliation
- Baptist Health CorbinCorbin, KY
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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All 109 physician assistants in Idaho Falls · All physician assistants in Idaho