Individual provider Active NPI

Jaren Mills, PA-C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1396112041
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9578313-1206 Issued in UT
Practice address
4700 Harrison Blvd
Ogden, UT 84403-4303
Phone
(801) 475-3300
Fax
(801) 475-3301
NPI assigned
Aug 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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 9578313-1206 UT Primary

Addresses

Primary practice location

4700 Harrison Blvd
Ogden, UT 84403-4303

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3300

Other identifiers 1

IdentifierTypeStateIssuer
1396112041MedicaidUT

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
I20151228002093 UT Practitioner - Physician Assistant 5395046809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic Specialty Services LLCGroup PAC ID 1658781422, 131 clinicians

Practice addresses (Care Compare)

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3482

4700 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3300

5475 S 500
Ogden, UT 84405-6905
Phone (801) 479-2570

6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800

Hospital & facility affiliations

  • Symbii Home Health Home health agency, Layton, UT, CCN 467231
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1396112041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3300",
            "fax_number": "801-475-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3300",
            "fax_number": "801-475-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "JAREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9578313-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396112041",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.