Jared Blake Allan, AGACNP
Individual provider Active NPI Nurse Practitioner · Murray, UT
NPI 1659080927 · NPPES record last updated Mar 9, 2026
Key facts
- NPI
- 1659080927
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 9046989-3102 (UT)
- Practice address
- 5121 S Cottonwood St
Murray, UT 84107-5701 - Phone
- (801) 507-7000
- NPI assigned
- Nov 16, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-4384
Hospital & facility affiliations
- Intermountain Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230713002926 | UT | Practitioner - Nurse Practitioner | 0941660518 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9046989-3102 | UT | Yes |
| Acute Care Nurse Practitioner | 363LA2100X | 9046989-4405 | UT |
Addresses
Primary practice location
5121 S Cottonwood St
Murray, UT 84107-5701
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
8th Avenue C St E
Salt Lake City, UT 84143-3104
Phone (801) 408-1100
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService | Other | Bluemark LLC / Office Ally |
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.