Jeremy Robert Chidester, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

10668647-1205 Issued in UT

Practice address

1309 W South Jordan Pkwy Ste 110
South Jordan, UT 84095-9014

Phone

(801) 839-5557

Fax

(801) 770-4455

NPI assigned

Apr 18, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ward MD LLC

  • Facial Plastic Surgery Physician
  • Salt Lake City, UT
  • NPI 1114378023
  Medicare reassignment NPD
• Highpointe Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Draper, UT
  • NPI 1982449500
  NPD Authorized official
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Moab, UT
  • NPI 1306070248
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1194015693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 W SOUTH JORDAN PKWY STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959014",
            "telephone_number": "801-839-5557",
            "fax_number": "801-770-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W SOUTH JORDAN PKWY STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959014",
            "telephone_number": "801-839-5557",
            "fax_number": "801-770-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDESTER",
        "first_name": "JEREMY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "UT",
            "license": "10668647-1205",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "10668647-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Healthcare
• Josephine Chau
• Lisa D Chavez, APC
• Halie Elizabeth Checketts, LCSW
• Mkell Chevalier
• Paul Lorin Child Jr., DMD, CDT
• Heidi Childs
• April Chlarson, LCSW
• Choice Care Clinic of Utah, Inc.
• Christensen Orthodontics LLC

• Plastic Surgery Physician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.

Verify at the official NPI Registry.