Melvin Terry Jeppson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M5646 Issued in ID

Practice address

1501 Hiland Ave
Suite B
Burley, ID 83318-2682

Phone

(208) 878-2229

Fax

(208) 878-4599

NPI assigned

Aug 24, 2005

Reactivated

Apr 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Obstetrics/Gynecology

Education

University of Utah School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cassia Regional Hospital Hospital, Burley, ID, CCN 131326

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drjobg@direct.practicefusion.com
• Direct secure messaging: mjeppson623287@direct.ochin.org

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Burley, ID
  • NPI 1710156922
  Medicare reassignment NPD
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Burley, ID
  • NPI 1497865315
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1285019737
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Burley, ID
  • NPI 1497865315
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1114910296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "SUITE B1",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-878-2229",
            "fax_number": "208-878-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "SUITE B",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-878-2229",
            "fax_number": "208-878-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPSON",
        "first_name": "MELVIN",
        "middle_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "deactivation_date": "2006-04-03",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M5646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002663900",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drjobg@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "EMR connection",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 Hiland Ave",
            "address_2": "Suite B",
            "city": "Burley",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833182682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Intermountain Medical Group Denver, LLC
• Christian Jackson
• Duane Jeffers, MD
• Maria G Jensen, RN, ICADC
• William F Jensen, MBA, ICADC
• Alicia Johnson
• Brian Johnson, PA-C
• Evan Johnson, PA-C
• Jared C Johnson, D.D.S.
• Anita Engstrom Jones, LCPC, LMFT

• Obstetrics & Gynecology Physician in Burley, ID
• Providers in Burley, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.