Jonas Legrand Peterson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

104427351205 Issued in UT

Practice address

4403 Harrison Blvd
Suite a-700
Ogden, UT 84403-3271

Phone

(801) 387-5300

Fax

(801) 387-5333

NPI assigned

Jun 7, 2016

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weber Human ServicesGroup PAC ID 3274430244, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Weber Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ogden, UT
  • NPI 1043243140
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Community Health Registered Nurse
  • Salt Lake City, UT
  • NPI 1437289386
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Weber Human Services

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1396355087
  NPD

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1114376431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE A-700",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE A-700",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JONAS",
        "middle_name": "LEGRAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "104427351205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colton Brad Peterson
• Courtney Peterson, LCSW
• Jason Peterson
• Jennifer Peterson, RN
• Jessica Lorraine Peterson
• Melissa Peterson, LMT
• Michelle Nicole Peterson, FNP-C
• Rex J. Peterson, D.D.S.
• Scott David Peterson, O.D.
• Nicole Peto, RN

• Family Medicine Physician in Ogden, UT
• Providers in Ogden, 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 May 6, 2019; 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.