Individual provider Active NPI

Jonathan Scott Shakespear, M.D.

  • Diagnostic Radiology Physician
  • Murray, UT
National Provider Identifier
1033367065
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6351781-1205 Issued in UT
Practice address
5444 S. Green St.
Murray, UT 84123-5632
Phone
(801) 262-8120
Fax
(801) 262-3897
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 6351781-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X 4301096633 MI
Diagnostic Radiology Physician 2085R0202X M-11422 ID

Addresses

Primary practice location

5444 S. Green St.
Murray, UT 84123-5632

Mailing address

5444 S. Green St.
Murray, UT 84123-5632
Phone (801) 262-8120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110726000086 UT Practitioner - Diagnostic Radiology 9436344611 Reassigns benefits to 3 organizations
I20110919000771 ID Practitioner - Diagnostic Radiology 9436344611 Reassigns benefits to 1 organization
I20260313003730 WA Practitioner - Diagnostic Radiology 9436344611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-11422IDMDDiagnostic Radiology Physician
4301096633MIMDDiagnostic Radiology Physician
6351781-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mountain Medical Physician Specialists PC Body Imaging CurrentSince Jul 1, 2011 Accepting new patients
Tellica Imaging, LLC CurrentSince Feb 21, 2022 Accepting new patients
Tellica Imaging, LLC CurrentSince Apr 13, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince Mar 13, 2023 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 28, 2026 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Sep 5, 2024 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2017 Accepting new patients
Tellica Imaging, LLC CurrentSince Feb 21, 2022 Accepting new patients
Central Utah Radiology, PC Diagnostic Radiology Past Accepting new patients
MMPS Murray Past Accepting new patients

Locations

8505 W Overland Rd
Boise, ID 83709
Phone (208) 417-5100

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

5334 S Woodrow St
#100
Salt Lake City, UT 84107
Phone (801) 284-1702

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1033367065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKESPEAR",
        "first_name": "JONATHAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "6351781-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301096633",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-11422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.