Active NPI
Jennie T Clarke, MD
- Dermatology Physician
- Salt Lake City, UT
National Provider Identifier
1447214655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 9067596-1205
- Practice address
- 50 N Medical Dr
Salt Lake City, UT 84132-0001 - Phone
- (801) 581-2955
- Fax
- (801) 581-2307
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 9067596-1205 | UT | Primary |
Addresses
Primary practice location
50 N Medical Dr
Salt Lake City, UT 84132-0001
Mailing address
PO Box 841052
Los Angeles, CA 90084-1052
Phone (801) 587-6340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012886430001 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jclarke120392@direct.med.utah.edu | Direct | University of Utah |
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
- Dermatology
- Education
- Pennsylvania State University College of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 587-6340
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.84 of 100
- Quality
- 87.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 52.42
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 693 |
| Removal or shaving of skin growth | 13 |
| Skin biopsy | 162 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Division University of Utah Medical Center | Dermatology | Current | Accepting new patients |
| U-U Pediatric Dermatology | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- jclarke120392@direct.med.utah.edu
Organizations & group practices 3
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.
-
- Dermatology Physician
- Salt Lake City, UT
- NPI 1922096114
-
- Pediatric Dermatology Physician
- Salt Lake City, UT
- NPI 1235339193
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1487734976
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1447214655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841052",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900841052",
"telephone_number": "801-587-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-581-2955",
"fax_number": "801-581-2307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "JENNIE",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "UT",
"license": "9067596-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1012886430001",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jclarke120392@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.