NPIMap

Individual provider Active NPI

Jon C Oberg, M.D.

  • Surgery Physician
  • Bountiful, UT
National Provider Identifier
1316035942
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
6885624-1205 Issued in UT
Practice address
440 Medical Dr
Bountiful, UT 84010-4950
Phone
(801) 499-0247
Fax
(800) 303-6743
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 6885624-1205 UT Primary

Addresses

Primary practice location

440 Medical Dr
Bountiful, UT 84010-4950

Mailing address

440 Medical Dr
Bountiful, UT 84010-4950
Phone (801) 499-0247

Other identifiers 1

IdentifierTypeStateIssuer
1316035942MedicaidUT

Other names 1

  • Dr. Jon C E Oberg Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080828000086 UT Practitioner - General SurgeryPractitioner - Vascular Surgery 6204868557 Reassigns benefits to 1 organization
Practice locations: Bountiful, UT

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Southern California Keck School of Medicine, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 4168
Pocatello, ID 83205

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion25
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic Surgery Current Accepting new patients
Tanner Memorial Clinic CurrentSince May 5, 2014 Accepting new patients
Tanner Memorial Clinic CurrentSince May 5, 2014 Accepting new patients
Lakeview Urology & General Surgery LLC Surgery Past Accepting new patients
Davis County General Surgery, P.L.L.C Surgery PastSince Dec 15, 2025 Accepting new patients
Scott a Erickson MD, PC PastSince Jul 1, 2005 Accepting new patients
Lakeview Internal Medicine, LLC Surgery Past Accepting new patients
Bountiful Surgical Associates Surgery PastSince Jul 14, 2008 Accepting new patients
Northern California Surgical Group a Med Corp Surgery Past Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1693/brand/1/csg/1/fhir/r4

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 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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1316035942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104950",
            "telephone_number": "801-499-0247",
            "fax_number": "800-303-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104950",
            "telephone_number": "801-499-0247",
            "fax_number": "800-303-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERG",
        "first_name": "JON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "6885624-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316035942",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JON",
            "last_name": "OBERG",
            "middle_name": "C E",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.