Peguy Jacques

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9571169-4405 Issued in UT

Practice address

2008 E Chariot LN
Spanish Fork, UT 84660-6284

Phone

(801) 623-3346

NPI assigned

Oct 6, 2017

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, AZ, WV3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pjacques199914@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Nurse Practitioner

  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• Woundtech of Utah, Inc.

  • Infectious Disease Physician
  • Salt Lake City, UT
  • NPI 1750922415
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  Nurse Practitioner, WV

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ, Nurse Practitioner, UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  dba UVRMC Physicians Billing

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1407099302
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah Adult Services

  dba Univ. of Utah Hosp. Gen. Med. Division

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1356745152
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1578073250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 E CHARIOT LN",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846606284",
            "telephone_number": "801-623-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 E CHARIOT LN",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846606284",
            "telephone_number": "801-623-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "PEGUY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-06",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9571169-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9571169-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjacques199914@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": []
}

• Ivee Mobile Hydration (Advanced Mobile IV of Provo/Spanish Fork)
• Ivee Restorative Care
• Jill Ivie
• Paige Jackson
• Emily Jacobs
• Grace Lynn Jenkins
• Joanna Jenkins
• Ashley Jensen
• Allison May Jenson, DPT
• Cambree John

• Family Nurse Practitioner in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.