Heber Valley Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

HEBER VALLEY DERMATOLOGY

Practice address

322 E Gateway Dr Ste 103
Heber City, UT 84032-4611

Phone

(435) 315-3147

Fax

(435) 355-3737

NPI assigned

Jun 9, 2021

Organization subpart

No

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

Authorized official

Name

Jessica Collins, DO

Title

Physician Owner

Phone

(606) 694-2836

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1174190003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E GATEWAY DR STE 103",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324611",
            "telephone_number": "435-315-3147",
            "fax_number": "435-355-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E GATEWAY DR STE 103",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324611",
            "telephone_number": "435-315-3147",
            "fax_number": "435-355-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBER VALLEY DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "606-694-2836",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hebervalleydermatology@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "Encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "322 E Gateway Dr Ste 103",
            "city": "Heber City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840324611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jesse Hawkes, M.D.
• Heber City Dental
• Heber Opco LLC
• Heber PDC PLLC
• Heber Valley Chiropractic LLC
• Heber Valley Internal Medicine
• Heber Valley Medical LLC
• Heber Valley Oral & Maxillofacial Surgery
• Heber Valley Pediatric
• Heber Valley Physical Therapy Inc

• Dermatology Physician in Heber City, UT
• Providers in Heber City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.