Individual provider Active NPI

John Reagan, DPM

  • Podiatrist
  • North Salt Lake, UT
National Provider Identifier
1275896359
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
8716994-0501 Issued in UT
Practice address
731 Skipton
North Salt Lake, UT 84054-6071
Phone
(801) 842-6058
NPI assigned
Jun 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 8716994-0501 UT Primary

Addresses

Primary practice location

731 Skipton
North Salt Lake, UT 84054-6071

Mailing address

731 Skipton
North Salt Lake, UT 84054-6071
Phone (801) 842-6058

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001548 UT Practitioner - Podiatry 0345543526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2012
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)

3723 W 12600
Suite 150
Riverton, UT 84065-7296
Phone (801) 285-4560

Hospital & facility affiliations

  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue20
Removal of skin lesions1-10
Removal of nail tissue395
Removal or shaving of skin growth187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8716994-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2016 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2016 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

3723 W 12600 S
Ste 460
Riverton, UT 84065
Phone (801) 285-4650

3723 W 12600 S
Riverton, UT 84065
Phone (801) 285-2482

3723 W 12600 S
Ste 330
Riverton, UT 84065
Phone (801) 285-4543

3723 W 12600 S
Ste 150
Riverton, UT 84065
Phone (801) 285-4560

5848 S Fashion Blvd
Ste 120
Salt Lake City, UT 84107
Phone (801) 314-4100

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 and National Provider Directory roles.

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1275896359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 SKIPTON",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840546071",
            "telephone_number": "801-842-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 SKIPTON",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840546071",
            "telephone_number": "801-842-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "JOHN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "8716994-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Salt Lake, UT

Sources for this page

Verify at the official NPI Registry.