Individual provider Active NPI

Jonathan Rodger Wood, MD

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1255567947
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12974760-1205 Issued in UT
Practice address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 487-0451
Fax
(801) 487-2467
NPI assigned
Jun 8, 2009
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 2019039191 MO
Diagnostic Radiology Physician 2085R0202X 12974760-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X 2019039191 MO

Addresses

Primary practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone (314) 362-7200

Other identifiers 1

IdentifierTypeStateIssuer
200089878MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, UT, ID, WA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20201216000388 MO Practitioner - Diagnostic Radiology 6406193770 Reassigns benefits to 2 organizations
I20230609001863 UT Practitioner - Diagnostic Radiology 6406193770 Reassigns benefits to 4 organizations
I20240103001425 ID Practitioner - Diagnostic Radiology 6406193770 Reassigns benefits to 1 organization
I20260227000504 WA Practitioner - Diagnostic Radiology 6406193770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Rochester School of Medicine and Dentistry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 408-1146

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2019039191MOMDPediatric Radiology Physician
12974760-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 26, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Miracl, LLC CurrentSince Nov 1, 2020 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 13, 2026 Accepting new patients
University of Utah Pediatric Services CurrentSince May 1, 2023 Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince Jun 26, 2023 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
Tellica Imaging, LLC CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services, Inc. Current Accepting new patients
University of Utah Pediatric Services CurrentSince May 1, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 9, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Washington University Pediatric Radiology CurrentSince Nov 1, 2020 Accepting new patients
Carilion Medical Center Past Accepting new patients
Barnes Jewish St Peters Hospital Inc Past Accepting new patients
Missouri Baptist Hospital of Sullivan Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology PastSince Oct 5, 2025 Accepting new patients
Carilion New River Valley Medical Center Past Accepting new patients
Barnes Jewish Hospital Past Accepting new patients
Barnes Jewish West County Hospital Past Accepting new patients
Missouri Baptist Medical Center Past Accepting new patients
Progress West Healthcare Center Past Accepting new patients
St Louis Childrens Hospital Past Accepting new patients
University of Utah Past Accepting new patients
Christian Hospital Northeast- Northwest Past Accepting new patients
Barnes Jewish Hospital Past Accepting new patients
Carilion Franklin Memorial Hospital Past Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

8505 W Overland Rd
Boise, ID 83709
Phone (208) 417-5100

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2911

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

1887 Whitney Mesa Dr
Henderson, NV 89014
Phone (702) 819-0368

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

421 E Main St
Auburn, WA 98002
Phone (253) 204-2530

2941 S 38th St
Ste E
Tacoma, WA 98409
Phone (253) 534-8689

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 32

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.

View all 32

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1255567947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-487-0451",
            "fax_number": "801-487-2467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101016",
            "country_code": "US",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JONATHAN",
        "middle_name": "RODGER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MO",
            "license": "2019039191",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "12974760-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019039191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089878",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.