Individual provider Active NPI

Jeffrey C Walker, M.D.

  • Trauma Surgery Physician
  • Ogden, UT
National Provider Identifier
1609167063
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
130847551205 Issued in UT
Practice address
4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277
Phone
(801) 387-7450
Fax
(385) 297-2647
NPI assigned
Apr 20, 2011
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Student in an Organized Health Care Education/Training Program 390200000X 4301099240 MI
Surgical Critical Care Physician 2086S0102X 130847551205 UT
Surgical Critical Care Physician 2086S0102X 4301099240 MI
Trauma Surgery Physician 2086S0127X 130847551205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170914002144 ID Practitioner - General Surgery 3870743347 Reassigns benefits to 1 organization
I20230606001281 UT Practitioner - General Surgery 3870743347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2011
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)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

4403 Harrison Blvd
Suite 2645
Ogden, UT 84403-3278
Phone (801) 387-5620

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
130847551205UTMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 11, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 11, 2023 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Trauma Surgery Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Oct 5, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Oct 5, 2019 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

6140 W Curtisian Ave
Ste 2
Boise, ID 83704

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

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

4403 Harrison Blvd
Ste 2600
Ogden, UT 84403
Phone (801) 378-7450

4403 Harrison Blvd
Ste 2645
Ogden, UT 84403
Phone (801) 387-2880

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1609167063",
    "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",
            "fax_number": "385-297-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 2600",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033277",
            "telephone_number": "801-387-7450",
            "fax_number": "385-297-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301099240",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "UT",
            "license": "130847551205",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301099240",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "UT",
            "license": "130847551205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.