Individual provider Active NPI

Jacqueline Stuart Lloyd

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1255727731
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
UT10846260-1206 Issued in UT
Practice address
4403 Harrison Blvd Ste 2855
Ogden, UT 84403-3323
Phone
(801) 387-7150
Fax
(801) 387-7155
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X UT10846260-1206 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 2855
Ogden, UT 84403-3323

Mailing address

4403 Harrison Blvd Ste 2855
Ogden, UT 84403-3323
Phone (801) 387-7150

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200526003058 UT Practitioner - Physician Assistant 9032425780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195

4403 Harrison Blvd
Ogden, UT 84403-3271
Phone (801) 378-7450

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
UT10846260-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 21, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 21, 2020 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

201 W Layton Pkwy
Ste 2A
Layton, UT 84041
Phone (801) 387-7185

1281 N 600 E
Logan, UT 84341
Phone (435) 716-6400

4403 Harrison Blvd
Ste 3430
Ogden, UT 84403
Phone (801) 387-3866

4403 Harrison Blvd
Ste 2855
Ogden, UT 84403
Phone (801) 387-2550

4403 Harrison Blvd
Ste 1670
Ogden, UT 84403
Phone (801) 387-7125

4403 Harrison Blvd
Ste 3630
Ogden, UT 84403
Phone (801) 387-7900

5171 S Cottonwood St
Ste 610
Salt Lake City, UT 84107
Phone (801) 507-3630

Organizations & group practices 4

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.

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1255727731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 2855",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033323",
            "telephone_number": "801-387-7150",
            "fax_number": "801-387-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 2855",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033323",
            "telephone_number": "801-387-7150",
            "fax_number": "801-387-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLOYD",
        "first_name": "JACQUELINE",
        "middle_name": "STUART",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "UT10846260-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.