Individual provider Active NPI

Jody Jeppson Dutremble, PA-C

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1285975334
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8538228-1206 Issued in UT
Practice address
2075 University Park Blvd
Layton, UT 84041-1611
Phone
(801) 779-6200
NPI assigned
Mar 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8538228-1206 UT Primary

Addresses

Primary practice location

2075 University Park Blvd
Layton, UT 84041-1611

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 770-0414

Other names 1

  • Jody Jeppson Former name

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
I20140929002839 UT Practitioner - Physician Assistant 3870713670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
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)

1915 W 5950
Roy, UT 84067-1454
Phone (801) 387-8100

201 W Layton Pkwy
Layton, UT 84041-3692

2075 N 1200
Layton, UT 84041-1611
Phone (801) 779-6200

2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 387-6200

2400 N Washington Blvd
North Ogden, UT 84414-7233
Phone (435) 792-1770

5323 S Woodrow St
Murray, UT 84107-5841
Phone (801) 261-8346

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

9450 S 1300
Sandy, UT 84094-5555
Phone (801) 501-6250

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 4, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 4, 2018 Accepting new patients

Locations

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

2075 University Park Blvd
Layton, UT 84041
Phone (801) 367-2775

201 W Layton Pkwy
Ste 1A
Layton, UT 84041
Phone (801) 543-5875

Organizations & group practices 3

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": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1285975334",
    "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",
            "telephone_number": "801-770-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 UNIVERSITY PARK BLVD",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411611",
            "telephone_number": "801-779-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPSON DUTREMBLE",
        "first_name": "JODY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8538228-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "JEPPSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.