Jordan Russell Roberts, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9897039-1205 Issued in UT

Practice address

999 E Murray Holladay Rd Ste 207
Holladay, UT 84117-5093

Phone

(801) 268-2584

Fax

(801) 262-1168

NPI assigned

May 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jordan Essary Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arizona College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.roberts@gmcwv.eclinicaldirectplus.com

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.

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Utah Healthcare Institute Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1376597344
  Medicare reassignment NPD
• Granger Medical Clinic, PC

  • Sleep Medicine (Internal Medicine) Physician
  • Murray, UT
  • NPI 1447609987
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536969600000",
    "number": "1588043871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 E MURRAY HOLLADAY RD STE 207",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841175093",
            "telephone_number": "801-268-2584",
            "fax_number": "801-262-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 E MURRAY HOLLADAY RD STE 207",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841175093",
            "telephone_number": "801-268-2584",
            "fax_number": "801-262-1168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E 3900 S Ste 260",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241371",
            "country_code": "US",
            "telephone_number": "801-265-2000 x120",
            "fax_number": "801-265-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JORDAN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2018-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9897039-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "ESSARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rice Family Pharmacy LLC
• Jameson Allen Rice, PHARMD
• Daniel Robbins, PHARM D
• Robert B Topham
• Chelsea Roberts
• Tracy James Robinson, M.D.
• Lewis T Rollins Jr., MASSAGE THERAPIST
• Elizabeth Lowry Rosioru
• Lillian Rowe, DNP, APRN, PMHNP-BC
• Ryan James Rowell, D.C.

• Family Medicine Physician in Holladay, UT
• Providers in Holladay, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2018; 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.