NPIMap

Individual provider Active NPI

Jace Dakota Johnny, DNP, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1558920835
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9106759-4405 Issued in UT
Practice address
2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550
Phone
(801) 869-0876
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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 Nurse Practitioner 363LC0200X 9106759-4405 UT
Acute Care Nurse Practitioner 363LA2100X 9106759-4405 UT Primary

Addresses

Primary practice location

2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550

Mailing address

2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550
Phone (801) 869-0876

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjohnny119055@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918003057 UT Practitioner - Nurse Practitioner 6204166184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-3229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
90.35 of 100Reported as group
Quality
72.06
Promoting interoperability
100
Improvement activities
40
Cost
72.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services CurrentSince Jul 21, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Jul 21, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Jul 21, 2019 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Acuity Care Services CurrentSince Jul 21, 2019 Accepting new patients

Locations

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

127 S 500 E
Salt Lake Cty, UT 84102

2000 Circle of Hope Dr
Slc, UT 84112
Phone (801) 581-7840

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 5

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1558920835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-869-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-869-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNNY",
        "first_name": "JACE",
        "middle_name": "DAKOTA",
        "credential": "DNP, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "UT",
            "license": "9106759-4405",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "9106759-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnny119055@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

Verify at the official NPI Registry.