Individual provider Active NPI

Jana Wold, M.D.

  • Specialist
  • Salt Lake City, UT
National Provider Identifier
1265630313
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6359075-8905 Issued in UT
Practice address
175 N Medical Dr FL 3
Salt Lake City, UT 84132-0001
Phone
(801) 587-9935
Fax
(801) 587-8039
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 6359075-1205 UT
Specialist 174400000X 6359075-8905 UT Primary

Addresses

Primary practice location

175 N Medical Dr FL 3
Salt Lake City, UT 84132-0001

Mailing address

1352 South 900 East
Salt Lake City, UT 84105
Phone (801) 647-5383

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwold5124@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID, CO3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20090826000217 UT Practitioner - NeuropsychiatryPractitioner - Neurology 9335294479 Reassigns benefits to 1 organization
I20210421002797 ID Practitioner - Neuropsychiatry 9335294479 Reassigns benefits to 1 organization
I20230118001246 CO Practitioner - Neurology 9335294479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeuropsychiatryAlso: Neurology
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6359075-8905UTMDSpecialist
6359075-1205UTMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Healthcare System CurrentSince Oct 15, 2022 Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince Mar 1, 2021 Accepting new patients
Colorado West Healthcare System CurrentSince Oct 15, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
Pocatello Health Services, LLC CurrentSince Mar 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

729 S Arapeen Dr
Slc, UT 84108
Phone (801) 585-1341

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

Interoperability endpoints

  • Direct secure messaging: jwold5124@direct.med.utah.edu

Organizations & group practices 9

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 4

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1265630313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 SOUTH 900 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84105",
            "telephone_number": "801-647-5383",
            "fax_number": "801-587-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N MEDICAL DR FL 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-587-9935",
            "fax_number": "801-587-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLD",
        "first_name": "JANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "UT",
            "license": "6359075-1205",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "6359075-8905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwold5124@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "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.