Active NPI
Matthew Naegle, DO
- Pediatrics Physician
- Ogden, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 70007041204
- Practice address
- 698 12TH St
Ogden, UT 84404-6200 - Phone
- (801) 475-3700
- Fax
- (801) 475-3701
- NPI assigned
- Jun 8, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R-10913 | IA | |
| Pediatrics Physician | 208000000X | 70007041204 | UT | Primary |
Addresses
Primary practice location
698 12TH St
Ogden, UT 84404-6200
Mailing address
PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154850477 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, GU
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-10913 | IA | MD | Pediatrics Physician |
| 70007041204 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guam Memorial Hospital | Current | Accepting new patients | |
| Guam Memorial Hospital | Current | Accepting new patients | |
| Ogden Clinic PC | Pediatrics | Current | Accepting new patients |
| Tanner Memorial Clinic | Current | Accepting new patients | |
| Tanner Memorial Clinic | Pediatrics | Current | Accepting new patients |
| Tanner Memorial Clinic | Current | Accepting new patients |
Locations
850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555
850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552
444 W Bourne Cir
Farmington, UT 84025
425 S 100 W
Layton, UT 84041
Phone (801) 682-8708
698 12th St
Ogden, UT 84404
Phone (801) 475-3700
1159 12th St
Ogden, UT 84404
Phone (801) 475-3700
5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100
6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800
Interoperability endpoints
- matthew.naegle.p1@direct.tannerclinic.nextgenshare.com
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Oka Tamuning, GU
- NPI 1366519027
-
- Multi-Specialty Clinic/Center
- Layton, UT
- NPI 1538951165
-
- Multi-Specialty Clinic/Center
- Layton, UT
- NPI 1710667282
-
- Skilled Nursing Facility
- Oka Tamuning, GU
- NPI 1952479131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1154850477",
"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": "801-475-3500",
"fax_number": "801-475-3494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "698 12TH ST",
"city": "OGDEN",
"state": "UT",
"postal_code": "844046200",
"telephone_number": "801-475-3700",
"fax_number": "801-475-3701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAEGLE",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-08",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "R-10913",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "70007041204",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154850477",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.