Jonathan M Gardner, M.D.
Individual provider Active NPI Family Medicine Physician · Tremonton, UT
NPI 1154600922 · NPPES record last updated Aug 10, 2021
Key facts
- NPI
- 1154600922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 8390890-1205 (UT)
- Practice address
- 935 N 1000 W
Tremonton, UT 84337-9356 - Phone
- (435) 207-4800
- Fax
- (435) 207-4808
- NPI assigned
- Aug 11, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
935 N 1000
Tremonton, UT 84337-9356
Phone (435) 207-4800
Hospital & facility affiliations
- Intermountain Health Home Health - Logan
- Ascend Home Health
- Bear River Valley Hospital
- Intermountain Health Logan Regional Hospital
- Intermountain Health McKay-Dee Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121004000876 | UT | Practitioner - Family Practice | 3072762178 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8390890-1205 | UT | MD | Family Medicine Physician |
| M12339 | ID | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Family Medicine | Current |
Accepting new patients |
| Ihc Health Services Inc | Family Medicine | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
412 N 200 E
Logan, UT 84321
Phone (435) 713-2710
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
935 N 1000 W
Tremonton, UT 84337
Phone (435) 207-4800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | M12339 | ID | |
| Family Medicine Physician | 207Q00000X | 8390890-1205 | UT | Yes |
| Family Medicine Physician | 207Q00000X | M12339 | ID |
Addresses
Primary practice location
935 N 1000 W
Tremonton, UT 84337-9356
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 207-4800
Other practice location 1
360 E. Liberty
Weiser, ID 83672
Phone (208) 414-1124
Other practice location 2
360 E. Liberty
Weiser, ID 83672
Phone (208) 414-1124
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jonathan.gardner@direct.imail.org |
Other providers in Tremonton, UT
- Essence of Health
- Christopher Falslev
- Anthony Farlaino
- Morgan Farnsworth
- Brooke Freeze
- Ricky Lane Gardner
- Rodney Gardner
- Rodney Tyson Gardner I
- John Joseph Gauruder
- Kristina C Gerlach
All providers in Tremonton, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.