JCD Enterprises, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9115648-0160 Issued in UT

Legal business name

JCD ENTERPRISES, LLC

Practice address

3352 W Merryvale Cir
Riverton, UT 84065-6045

Phone

(801) 903-1122

NPI assigned

Aug 19, 2014

Organization subpart

No

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

Authorized official

Name

Jared Dunn, MD

Title

Owner

Phone

(801) 419-5024

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Thomas Grissom II, M.D.

  • Interventional Pain Medicine Physician
  • Wasilla, AK
  • NPI 1598789513
  NPD (past)
• Zachary A Kile, PA

  • Physician Assistant
  • Renton, WA
  • NPI 1922162510
  NPD (past)

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1114326709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521593",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841521593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3352 W MERRYVALE CIR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656045",
            "telephone_number": "801-903-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCD ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-419-5024",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9115648-0160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "9115648-0160",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Jean Jacob
• Darren C Jacobsen, MD
• Matthew Vaughn Jacobsen, DDS
• Katelyn Jaeger
• Tatum Jayde Jaster
• Eric Jacob Jemison, D.O.
• Heather Christine Jenkins, CMHC
• Amanda Jensen
• Jeffrey Simon Jensen, D.C.
• Michael Jensen, LCSW

• Family Medicine Physician in Riverton, UT
• Providers in Riverton, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.