NPIMap

Organization Active NPI

Jason B Dickerson DPM LC

Doing business as Utah Bone and Joint Specialists

  • Foot & Ankle Surgery Podiatrist
  • Murray, UT
National Provider Identifier
1164925467
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
JASON B DICKERSON DPM LC
Doing business as
Utah Bone and Joint Specialists
Practice address
5801 S Fashion Blvd Ste 120
Murray, UT 84107-8115
Phone
(801) 261-1391
NPI assigned
Mar 13, 2018
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Whitney Lofthouse
Title
Credentialing Specialist
Phone
(530) 925-6027

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X 4830364-0501 UT
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

5801 S Fashion Blvd Ste 120
Murray, UT 84107-8115

Mailing address

5801 S Fashion Blvd Ste 120
Murray, UT 84107-8115
Phone (801) 261-1391

Other practice location 1

1184 E 80 N
American Fork, UT 84003-2906
Phone (801) 763-3885

Other practice location 2

504 E 770 N
Orem, UT 84097-4101
Phone (801) 765-1718

Other practice location 3

97 Professional Way
Payson, UT 84651-1614
Phone (801) 765-1718

Other practice location 4

2326 N 400 E Ste 102
Tooele, UT 84074-3460
Phone (801) 261-1391

Other names 1

  • Utah Bone and Joint Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171206002217 UT DME Supplier - Physician - Podiatry 0345507984 Practice locations: Murray, UT
O20180323001277 UT Part B Supplier - Clinic/Group Practice 0345507984 Receives reassigned benefits from 1 practitioner
Practice locations: Tooele, UT; Springville, UT; Payson, UT; Orem, UT; Navajo Mountain, UT; Monument Valley New, UT; Murray, UT; American Fork, UT…

National Provider Directory

National Provider Directory

Locations

97 Professional Way
Payson, UT 84651
Phone (801) 465-4474

5801 S Fashion Blvd
Ste 120
Salt Lake Cty, UT 84107
Phone (801) 261-1391

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1164925467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD STE 120",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078115",
            "telephone_number": "801-261-1391",
            "fax_number": "801-261-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD STE 120",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078115",
            "telephone_number": "801-261-1391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1184 E 80 N",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032906",
            "country_code": "US",
            "telephone_number": "801-763-3885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 E 770 N",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "840974101",
            "country_code": "US",
            "telephone_number": "801-765-1718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Professional Way",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "UT",
            "postal_code": "846511614",
            "country_code": "US",
            "telephone_number": "801-765-1718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2326 N 400 E Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840743460",
            "country_code": "US",
            "telephone_number": "801-261-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JASON B DICKERSON DPM LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "LOFTHOUSE",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "530-925-6027"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "4830364-0501",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Bone and Joint Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.