Shae Lyn Whitaker, CNM

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

10538889-4402 Issued in UT

Practice address

4401 Harrison Blvd
Ogden, UT 84403-3195

Phone

(801) 475-3240

NPI assigned

Oct 15, 2026

Last updated

Oct 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shae Lyn Jackman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1255237442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 S 3585 W",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840755012",
            "telephone_number": "801-648-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-475-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "SHAE",
        "middle_name": "LYN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "10538889-4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAE",
            "last_name": "JACKMAN",
            "middle_name": "LYN",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laurel Whetton, RN
• Gary Lynn Whipple, M.D.
• Robert D Whipple, MD
• Angela Whisler
• Scott D Whitaker, CRNA,MS
• Chaz Whitbeck
• Chelsea Wheeler Whitby, ACMHC
• Anarie White, LCSW
• Ciera Alexis White, MS, TRS, CTRS
• Justin Shane White, D.O.

• Obstetrics & Gynecology Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Obstetrics & Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.