Individual provider Active NPI

Jared W Ollerton, CRNA

  • Certified Registered Nurse Anesthetist
  • Provo, UT
National Provider Identifier
1265554844
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
353604-4406 Issued in UT
Practice address
320 River Park Dr Ste 125
Provo, UT 84604-5787
Phone
(801) 375-8049
Fax
(801) 374-9195
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 353604-4406 UT Primary

Addresses

Primary practice location

320 River Park Dr Ste 125
Provo, UT 84604-5787

Mailing address

PO Box 1727
Provo, UT 84603-1727
Phone (801) 375-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050701000311 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921044710 Reassigns benefits to 2 organizations
I20071009000392 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921044710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Anesthesia LCGroup PAC ID 5991604829, 32 clinicians

Practice addresses (Care Compare)

750 W 800
Orem, UT 84057-3660
Phone (801) 714-6000

Hospital & facility affiliations

  • Timpanogos Regional Hospital Hospital, Orem, UT, CCN 460052
  • Mountain View Hospital Hospital, Payson, UT, CCN 460013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
353604-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
NPH Anesthesia of Utah, LLC Anesthesiology CurrentSince Aug 9, 2023 Accepting new patients
Madison Anesthesia Services PA Anesthesiology CurrentSince Sep 24, 2007 Accepting new patients
Mountain View Anesthesia LC Anesthesiology CurrentSince Nov 25, 2024 Accepting new patients
Eastern Utah Surgical Center Past Accepting new patients
Eastern Utah Surgical Center Past Accepting new patients
Riverwoods Anesthesia PLLC Anesthesiology PastSince Jun 14, 2016 Accepting new patients

Locations

2290 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-4000

37 S 2nd E
Rexburg, ID 83440
Phone (208) 356-0234

381 E 4th N
Rexburg, ID 83440
Phone (208) 359-2300

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1954 E Fort Union Blvd
Ste 105
Salt Lake Cty, UT 84121
Phone (801) 993-9524

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1265554844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846031727",
            "telephone_number": "801-375-8049",
            "fax_number": "801-374-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR STE 125",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045787",
            "telephone_number": "801-375-8049",
            "fax_number": "801-374-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLERTON",
        "first_name": "JARED",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "353604-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.