Active NPI
Jordan Gaudio, MD
- Pediatrics Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13384855-1205
- Practice address
- 1034 N 500 W
Provo, UT 84604-3380 - Phone
- (801) 357-1700
- NPI assigned
- Apr 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13384855-1205 | UT | Primary |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 13384855-1205 | UT |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604-3380
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-3670
Other names 1
- Jordan Derck
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jgaudio638724@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13384855-1205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Pediatric Acuity Care | Pediatrics | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| Wasatch Pediatrics, Inc | Pediatrics | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Pediatric Critical Care Medicine Physician
- Salt Lake City, UT
- NPI 1619325131
Pediatrics
-
- Obstetrics & Gynecology Physician
- Provo, UT
- NPI 1114191517
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Pediatric Hospice and Palliative Medicine Physician
- Salt Lake City, UT
- NPI 1851898365
-
- Pediatrics Physician
- West Jordan, UT
- NPI 1124102595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764547200000",
"number": "1063946325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043380",
"telephone_number": "801-357-1700"
}
],
"practiceLocations": [
{
"address_1": "111 Michigan Ave NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200102916",
"country_code": "US",
"telephone_number": "202-476-3670",
"fax_number": "202-476-4741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAUDIO",
"first_name": "JORDAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-13",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "13384855-1205",
"primary": true
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "UT",
"license": "13384855-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jgaudio638724@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JORDAN",
"last_name": "DERCK",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.