Jacob Wayne Moss, M.D., J.D.

General Practice Physician · Saint Anthony, ID

Individual Active NPI

NPI number 1205179751

Practice location

335 E Main St Ste 1
Saint Anthony, ID 83445-1546
Phone
(208) 356-4900
Fax
(208) 624-4116

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NPI record

NPI
1205179751
Entity type
Individual (Type 1)
Enumeration date
April 3, 2013
Last updated
October 15, 2025
Certified
October 15, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X M-14547 ID
General Practice Physician 208D00000X TM190 GA

Mailing address

PO Box 18
Saint Anthony, ID 83445-0018
Phone
(208) 356-4900
Fax
(208) 624-4112

Other practice locations (2)

  • 72 S 1st E Ste 101, Rexburg, ID 83440-1902 · (208) 356-4900
  • 3724 Woodking Dr Ste 1, Idaho Falls, ID 83404 · (208) 356-4900

About Dr. Moss

Jacob Wayne Moss, M.D., J.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 335 E Main St Ste 1, Saint Anthony, ID 83445-1546. The NPI number 1205179751 was assigned on April 3, 2013 and the record was last updated on October 15, 2025.

Dr. Moss lists 2 licenses in the registry: #M-14547 (ID) for General Practice Physician; #TM190 (GA) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacob Wayne Moss, M.D., J.D.?

The NPI number is 1205179751.

What is the phone number of Dr. Moss?

The phone number listed for the practice location is (208) 356-4900.

Where is Dr. Moss located?

335 E Main St Ste 1, Saint Anthony, ID 83445-1546.

What is the taxonomy code for Dr. Moss?

The primary taxonomy code is 208D00000X – General Practice Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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