Active NPI
Jed Craig Southwick, M.D.
- Emergency Medicine Physician
- Ogden, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 6456430-1205
- Practice address
- 4401 Harrison Blvd
Ogden, UT 84403-3195 - Phone
- (801) 387-7615
- NPI assigned
- May 22, 2007
- Last updated
- Nov 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 6456430-1205 | UT | Primary |
| Emergency Medicine Physician | 207P00000X | 88435 | OH |
Addresses
Primary practice location
4401 Harrison Blvd
Ogden, UT 84403-3195
Mailing address
357 E 3700 N
North Ogden, UT 84414-2749
Phone (801) 782-5310
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Medical College of Wisconsin, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone (801) 507-9700
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.98 of 100
- Quality
- 85.2
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88435 | OH | MD | Emergency Medicine Physician |
| 6456430-1205 | UT | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Emergency Physicians | Emergency Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417
4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Salt Lake City, UT
- NPI 1588048979
-
dba IMED Physicians Billing
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health McKay-Dee Hospital
- General Acute Care Hospital
- Ogden, UT
- NPI 1194749580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195603200000",
"number": "1366651481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 E 3700 N",
"city": "NORTH OGDEN",
"state": "UT",
"postal_code": "844142749",
"telephone_number": "801-782-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 HARRISON BLVD",
"city": "OGDEN",
"state": "UT",
"postal_code": "844033195",
"telephone_number": "801-387-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHWICK",
"first_name": "JED",
"middle_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "UT",
"license": "6456430-1205",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "88435",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.