NPIMap

Individual provider Active NPI

Ann Jefferds, MD

  • Pulmonary Disease Physician
  • Salt Lake City, UT
National Provider Identifier
1386691558
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
181614-1205 Issued in UT
Practice address
University of Utah Medical Center 50 North # 160
Salt Lake City, UT 84132-2853
Phone
(801) 581-2121
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 181614-1205 UT
Pulmonary Disease Physician 207RP1001X 181614-1205 UT Primary

Addresses

Primary practice location

University of Utah Medical Center 50 North # 160
Salt Lake City, UT 84132-2853

Mailing address

324 Tenth Ave
Suite #160
Salt Lake City, UT 84103-2853
Phone (801) 408-5151

Other identifiers 6

IdentifierTypeStateIssuer
9200041OtherUTUNITED HEALTH CARE #
224997OtherUTALTIUS PROVIDER NUMBER
29652OtherUTPEHP PROVIDER #
010133899OtherUTTEAMSTERS #
110182384OtherUTRAILROAD EMPS INS ID
870623071OtherUTMOLINA PROVIDER #

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
I20040414001359 UT Practitioner - Internal MedicinePractitioner - Pulmonary Disease 4082608641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
University of Minnesota Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Olympus ClinicGroup PAC ID 8921991506, 10 clinicians

Practice addresses (Care Compare)

4624 S Holladay Blvd
Suite 100
Salt Lake City, UT 84117-7056
Phone (801) 277-2682

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181614-1205UTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olympus Clinic CurrentSince Jul 1, 2019 Accepting new patients

Locations

4624 S Holladay Blvd
Ste 100
Salt Lake Cty, UT 84117
Phone (801) 277-2682

Interoperability endpoints

  • Direct secure messaging: ann.jefferds@27705477693444.direct.elationemr.com

Organizations & group practices 1

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 6

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386691558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 TENTH AVE",
            "address_2": "SUITE #160",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032853",
            "telephone_number": "801-408-5151",
            "fax_number": "801-408-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH MEDICAL CENTER 50 NORTH # 160",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322853",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERDS",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "UT",
            "license": "181614-1205",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "UT",
            "license": "181614-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE #",
            "identifier": "9200041",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS PROVIDER NUMBER",
            "identifier": "224997",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP PROVIDER #",
            "identifier": "29652",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEAMSTERS #",
            "identifier": "010133899",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD EMPS INS ID",
            "identifier": "110182384",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA PROVIDER #",
            "identifier": "870623071",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.