Individual provider Active NPI

Chase Kirk Christensen, DPM

  • Podiatrist
  • West Jordan, UT
National Provider Identifier
1649894569
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
13244494-0501 Issued in UT
Practice address
3181 W 9000 S
West Jordan, UT 84088-5610
Phone
(801) 352-5900
NPI assigned
Jun 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5951001364 MI
Podiatrist 213E00000X 13244494-0501 UT Primary

Addresses

Primary practice location

3181 W 9000 S
West Jordan, UT 84088-5610

Mailing address

7181 S Campus View Dr
West Jordan, UT 84084-4312
Phone (801) 965-3600

Other practice location 1

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 696-6954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718004809 OR Practitioner - Podiatry 2961825088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Foot and Ankle LLCGroup PAC ID 3274628359, 4 clinicians

Practice addresses (Care Compare)

1904 E Barnett Rd
Medford, OR 97504-8262
Phone 5417763338202

Hospital & facility affiliations

  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions1-10
Removal of nail tissue238
Removal or shaving of skin growth158
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13244494-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Foot & Ankle, LLC Podiatrist CurrentSince Aug 5, 2024 Accepting new patients

Locations

1904 E Barnett Rd
Medford, OR 97504
Phone (541) 776-3338

Organizations & group practices 1

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": "1591401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1649894569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 S CAMPUS VIEW DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844312",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885610",
            "telephone_number": "801-352-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-696-6954",
            "fax_number": "810-606-5239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "CHASE",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-06",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5951001364",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "13244494-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.