Individual provider Active NPI

Jason T Lang, RN

  • Certified Registered Nurse Anesthetist
  • Ogden, UT
National Provider Identifier
1235783317
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9034821-4406 Issued in UT
Practice address
4364 Washington Blvd
Ogden, UT 84403-1866
Phone
(801) 479-4470
NPI assigned
Jul 28, 2019
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9034821-3102 AZ
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 9034821-4406 UT Primary

Addresses

Primary practice location

4364 Washington Blvd
Ogden, UT 84403-1866

Mailing address

6907 W Morrow Dr
Glendale, AZ 85308-5793

Other practice location 1

3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (801) 920-5350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230214002384 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032546049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt Ogden Anesthesia Group LLCGroup PAC ID 4587976436, 13 clinicians

Practice addresses (Care Compare)

4364 Washington Blvd
Ogden, UT 84403-1866
Phone (801) 479-4470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
9034821-3102AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Anesthesia Consultants P C Multi-Specialty PastSince Oct 1, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1235783317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 W MORROW DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4364 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-479-4470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3929 E Bell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322112",
            "country_code": "US",
            "telephone_number": "801-920-5350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANG",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-28",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "9034821-3102",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "9034821-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.