Individual provider Active NPI

Jessica Wozab, PA-C

  • Medical Physician Assistant
  • Roy, UT
National Provider Identifier
1093084295
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5776572-1206 Issued in UT
Practice address
3485 W 5200 S
Roy, UT 84067-9438
Phone
(801) 475-3900
Fax
(801) 475-3901
NPI assigned
Dec 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5776572-1206 UT Primary

Addresses

Primary practice location

3485 W 5200 S
Roy, UT 84067-9438

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000659 UT Practitioner - Physician Assistant 1951569508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

3485 W 5200
Ogden Clinic Grand View
Roy, UT 84067-9438
Phone (801) 475-3900

5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100

6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Current Accepting new patients

Locations

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

3485 W 5200 S
Roy, UT 84067
Phone (801) 475-3900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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 3

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": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1093084295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3900",
            "fax_number": "801-475-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 W 5200 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679438",
            "telephone_number": "801-475-3900",
            "fax_number": "801-475-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZAB",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "5776572-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

Verify at the official NPI Registry.