Jason C Hadley, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

6851419-1205 Issued in UT

Practice address

1560 Renaissance Towne Dr
Suite 210
Bountiful, UT 84010-7680

Phone

(801) 397-6100

Fax

(801) 397-6101

NPI assigned

Mar 13, 2008

Last updated

Jan 18, 2017By the provider in NPPES

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 identifiers 1

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

Dermatology

Education

Emory University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogden Clinic Specialty Services LLCGroup PAC ID 1658781422, 131 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

• Ogden Clinic Specialty Services LLC

  dba Ogden Clinic PC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668

  Dermatology

  Medicare reassignment Care Compare group NPD
• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083

  Dermatology

  Medicare reassignment NPD

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1619148129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-397-6100",
            "fax_number": "801-397-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 RENAISSANCE TOWNE DR",
            "address_2": "SUITE 210",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107680",
            "telephone_number": "801-397-6100",
            "fax_number": "801-397-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "JASON",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "6851419-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619148129",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherri Gunn, FNP-C
• Gunnison Valley Hospital (Monument Healthcare Stonecreek)
• Gunnison Valley Hospital (Monument Healthcare North Park)
• Karine Julie Hachon, CRNA
• Benjamin E Hadfield, D.D.S.
• Michael L Hadley, MD
• Brenna Hakes, RBT
• Adrienne Hale
• Gary Arvel Hale, R.PH
• Josie Kay Haley

• Dermatology Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.