Jennifer Holt Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7114800-1206 Issued in UT

Practice address

74 E 11800 S Ste 360
Draper, UT 84020-5006

Phone

(801) 260-3687

Fax

(801) 260-3688

NPI assigned

Sep 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Ashley Holt Other name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Professional Association ServicesGroup PAC ID 8921053349, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jhjohnson@entslc.emadirect.md

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.

• ENT Professional Association Services

  • Otolaryngology Physician
  • SLC, UT
  • NPI 1801857271
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1225288376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 E 11800 S STE 360",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205006",
            "telephone_number": "801-260-3687",
            "fax_number": "801-260-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E 11800 S STE 360",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205006",
            "telephone_number": "801-260-3687",
            "fax_number": "801-260-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "HOLT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7114800-8906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7114800-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HOLT",
            "middle_name": "ASHLEY",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Craig Johnson, D.O.
• Dana Johnson
• Jackson Johnson
• Jada Johnson
• Jade Johnson
• Melissa Lowder Johnson, APRN DNP PMHNP
• Sabrina Johnson
• Spencer Johnson, O.D.
• Jonathan Davis Counseling Services, LLC
• Jonathan J. Ririe, Inc.

• Physician Assistant in Draper, UT
• Providers in Draper, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.