NPIMap

Individual provider Active NPI

Jill Stratford Waldron, APRN, GNP-BC

  • Gerontology Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1083852677
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
279490-4405/APRN Issued in UT
Practice address
50 North Medical Drive
University of Utah Cardiology Clinic #10
Salt Lake City, UT 84132
Phone
(801) 585-5122
Fax
(801) 585-2319
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2794904405 UT
Gerontology Nurse Practitioner 363LG0600X 279490-4405/APRN UT Primary

Addresses

Primary practice location

50 North Medical Drive
University of Utah Cardiology Clinic #10
Salt Lake City, UT 84132

Mailing address

30 North 1900 East
Room 4A100
Salt Lake City, UT 84132
Phone (801) 585-5122

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwaldron2525@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000797 UT Practitioner - Nurse Practitioner 2264578020 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • Quality Solace Services Lifecares (HH) Home health agency, Holladay, UT, CCN 467329
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
  • Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
279490-4405/APRNUTMDGerontology Nurse Practitioner
2794904405UTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Precision Medical Care LLC CurrentSince Jul 31, 2021 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
Quality Health Inc. Past Accepting new patients

Locations

1633 W Innovation Way
Fl 5
Lehi, UT 84043
Phone (801) 699-6344

30 N 1900 E
Rm 4A100
Salt Lake City, UT 84132
Phone (801) 585-2341

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

Interoperability endpoints

  • Direct secure messaging: jwaldron2525@direct.med.utah.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1083852677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTH 1900 EAST",
            "address_2": "ROOM 4A100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-585-5122",
            "fax_number": "801-585-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTH MEDICAL DRIVE",
            "address_2": "UNIVERSITY OF UTAH CARDIOLOGY CLINIC #10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-585-5122",
            "fax_number": "801-585-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "JILL",
        "middle_name": "STRATFORD",
        "credential": "APRN, GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "2794904405",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "279490-4405/APRN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwaldron2525@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": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.