Jordan James Radandt

Primary specialty

PodiatristTaxonomy code 213E00000X

License

11313930-0501 Issued in UT

Practice address

3130 S Highland Dr # B4
Salt Lake City, UT 84106-3095

Phone

(801) 253-6886

Fax

(801) 253-6888

NPI assigned

May 13, 2018

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huhu Kam Memorial Hospital Hospital, Sacaton, AZ, CCN 031308

Merit-based Incentive Payment System (MIPS)

Final score

89.21 of 100Reported as group

Quality

76.88

Promoting interoperability

76

Improvement activities

40

Cost

73.83

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment Care Compare group NPD
• Ryan Scott Ellsworth, DPM

  • Foot Surgery Podiatrist
  • Atlanta, GA
  • NPI 1104130574

  UT

  Medicare reassignment
• Ellsworth Foot and Ankle Clinic

  dba Summit Foot and Ankle

  • Podiatrist
  • Salt Lake City, UT
  • NPI 1760151864
  NPD
• Summit Medical Care

  • Family Medicine Physician
  • Provo, UT
  • NPI 1881216646
  NPD
• Gila River Health Care

  dba DHS behavioral Health Out Patient Services

  • Community/Behavioral Health Agency
  • Sacaton, AZ
  • NPI 1417237074
  NPD

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

• Gila River Health Care Corporation

  dba Hu Hu Kam Memorial Hospital

  • Critical Access Hospital
  • Sacaton, AZ
  • NPI 1225023179
  Care Compare affiliation
• Gila River Health Care Corporation

  dba HuHuKam Memorial Hospital - EMS

  • Ambulance
  • Sacaton, AZ
  • NPI 1851441075

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1053801324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 W 12600 S STE 120",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967405",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 S HIGHLAND DR # B4",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063095",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 N 500 W Ste 103",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011552",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADANDT",
        "first_name": "JORDAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-13",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "11313930-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Rackham
• Aimee Lynn Rackliffe, OT
• Isaac Paul Rackliffe
• Courtney Ann Rada, MD
• Jacob Rada, DPT
• Olivia Radcliffe
• Maxwell Radecky
• Amanda B Radford
• Kristin Radi
• Gregory Radin, M.D.

• Podiatrist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.