1. Home
  2. Directory
  3. Idaho
  4. Ammon
  5. Counselor
  6. NPI Profile

JAXSON LAYNE STARK MS
NPI 1144559527
Counselor - Mental Health in Ammon, ID

Active since December 15, 2009PECOS EnrolledAccepts Medicare Assignment
2705 E 17TH ST, AMMON, ID 83406(208) 360-0067 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 6, 2023, Feb 21, 2017 (2 updates tracked since 2017).

About Jaxson Layne Stark Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAXSON LAYNE STARK MS (NPI 1144559527) is an individual mental health provider in Ammon, Idaho, licensed in Idaho (LCPC 5501) and active in the NPI registry since December 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1144559527
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJAXSON LAYNE STARKCredential: MS
Location Address2705 E 17TH STAmmon, ID 83406-6601
Mailing Address3770 N Haderlie LnIona, ID 83427-7723 · (208) 360-0067
Phone(208) 360-0067
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateDecember 15, 2009
Last NPPES UpdateDecember 6, 20232 updates tracked since enumeration
NPPES CertifiedDecember 6, 2023
✔ NPI 1144559527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in ID · LCPC 5501
2705 E 17TH ST, Ammon, ID 83406
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan, Select Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaxson Layne Stark Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204287162
PECOS Enrollment IDI20240104004885
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAYDE BARNES PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
JODI LYNN DENNETT
Counselor (Mental Health)
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
SARAH CLARK
Peer Specialist
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
SIU LING CHI
Counselor (Professional)
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
MRS. STEVIE N CLAXTON LMSW
Social Worker
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
DANIELA UGARTE RODRIGUEZ
Counselor (Mental Health)
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
COLIN WATERS
Counselor (Professional)
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500
KELLY STARK
Social Worker
2705 E 17TH ST
AMMON, ID 83406
Bonneville County (208) 346-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaxson Stark's NPI number?

The NPI number for Jaxson Stark is 1144559527. It was assigned to this individual provider in the NPPES registry on December 15, 2009.

Where is Jaxson Stark located?

Jaxson Stark practices at 2705 E 17th St, Ammon, ID 83406. The listed phone number is (208) 360-0067.

What is Jaxson Stark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jaxson Stark enrolled in Medicare?

Yes. Jaxson Stark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jaxson Stark accept?

Health plans from PacificSource Health Plans, Providence Health Plan, Select Health and University of Utah Health Plans list Jaxson Stark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jaxson Stark was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.