Individual provider Active NPI

Scot Bram Jensen, PA-C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1538112610
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4783572-1206 Issued in UT
Practice address
4403 Harrison Blvd
Ste 3490
Ogden, UT 84403-3271
Phone
(801) 387-2650
Fax
(801) 387-2655
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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 4783572-1206 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd
Ste 3490
Ogden, UT 84403-3271

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-2650

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
I20061020000120 UT Practitioner - Physician Assistant 4082610746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

201 W Layton Pkwy
Layton, UT 84041-3692
Phone (801) 543-6000

4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-2800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Sep 1, 2002 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 1, 2002 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

201 W Layton Pkwy
Ste 2A
Layton, UT 84041
Phone (801) 387-7185

4403 Harrison Blvd
Ste 3490
Ogden, UT 84403
Phone (801) 387-2650

4403 Harrison Blvd
Ste 3430
Ogden, UT 84403
Phone (801) 387-3866

4403 Harrison Blvd
Ste 3450
Ogden, UT 84403
Phone (801) 357-3850

4403 Harrison Blvd
Ste 3400
Ogden, UT 84403
Phone (801) 387-3400

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

935 N 1000 W
Tremonton, UT 84337
Phone (435) 207-4800

Organizations & group practices 4

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 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1538112610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-2650",
            "fax_number": "801-387-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "STE 3490",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-2650",
            "fax_number": "801-387-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SCOT",
        "middle_name": "BRAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4783572-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.