Individual provider Active NPI

Joseph Brent Hagloch, PA-C, RDN

  • Medical Physician Assistant
  • Murray, UT
National Provider Identifier
1568894707
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8733335-1206 Issued in UT
Practice address
5169 S Cottonwood St Ste 320
Murray, UT 84107-6768
Phone
(801) 507-2531
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 8733335-4901 UT
Medical Physician Assistant 363AM0700X 8733335-1206 UT Primary

Addresses

Primary practice location

5169 S Cottonwood St Ste 320
Murray, UT 84107-6768

Mailing address

5169 S Cottonwood St Ste 320
Murray, UT 84107-6768
Phone (801) 507-2531

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
I20200319000104 UT Practitioner - Physician Assistant 0345678769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
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

4401 Harrison Blvd
Ogden, UT 84403-3195

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8733335-4901UTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 5, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 5, 2020 Accepting new patients

Locations

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

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

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

5169 S Cottonwood St
Ste 320
Salt Lake City, UT 84107
Phone (801) 507-2531

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.

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1568894707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5169 S COTTONWOOD ST STE 320",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076768",
            "telephone_number": "801-507-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5169 S COTTONWOOD ST STE 320",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076768",
            "telephone_number": "801-507-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGLOCH",
        "first_name": "JOSEPH",
        "middle_name": "BRENT",
        "credential": "PA-C, RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "8733335-4901",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8733335-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.