Haley W Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11336450-1205 Issued in UT

Practice address

1900 N State St
Provo, UT 84604-1341

Phone

(801) 373-2001

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Utah School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

GFM HoldingsGroup PAC ID 5890264568, 2 clinicians

Shelly Savage M D LLCGroup PAC ID 7315917697, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
• Orem Community Hospital Hospital, Orem, UT, CCN 460043
• American Fork Hospital Hospital, American Fork, UT, CCN 460023

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• GFM Holdings

  • Family Medicine Physician
  • Provo, UT
  • NPI 1306795984
  Medicare reassignment Care Compare group NPD Authorized official
• Shelly Savage M D LLC

  • Family Medicine Physician
  • Provo, UT
  • NPI 1669652343
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491
  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Orem, UT
  • NPI 1801903240
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • American Fork, UT
  • NPI 1912014358
  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1396248159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 N 1325 W",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633283",
            "telephone_number": "385-450-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041341",
            "telephone_number": "801-373-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 W 940 N",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043301",
            "country_code": "US",
            "telephone_number": "801-357-7930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HALEY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11336450-1205",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Jackson
• Alexis Jackson
• Brooke Jackson
• Brooklynn Jackson
• Emilee Jackson
• Heather Kaye Jackson
• Jeffrey Brown Jackson, PH.D., LMFT
• John W Jackson, M.D.
• Mark Aaron Jackson
• Megan Jackson

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.

Verify at the official NPI Registry.