Jacquelin Foss Hardenbrook, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

11023A Issued in WY

Practice address

555 E Broadway Ave Ste 202
Jackson, WY 83001-8640

Phone

(307) 733-6520

Fax

(307) 733-3216

NPI assigned

Apr 14, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqui Foss Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Paintbrush Pediatrics, LC

  • Pediatrics Physician
  • Jackson, WY
  • NPI 1235862681
  NPD (past) Authorized official
• Teton Pediatrics PC

  dba Teton Pediatrics

  • Pediatrics Physician
  • Jackson, WY
  • NPI 1790388213
  Authorized official Same address or phone
• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  NPD (past)

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669891099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4182",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830014182",
            "telephone_number": "307-733-6520",
            "fax_number": "801-662-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY AVE STE 202",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018640",
            "telephone_number": "307-733-6520",
            "fax_number": "307-733-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mario Capecchi Dr",
            "address_2": "Pediatric Residency Office",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131103",
            "country_code": "US",
            "telephone_number": "801-662-5700",
            "fax_number": "801-662-5755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDENBROOK",
        "first_name": "JACQUELIN",
        "middle_name": "FOSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "11023A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUI",
            "last_name": "FOSS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracy Lyn Haling, PHARMD
• Jean Ann Hamilton, CRNA
• William David Hamilton, CRNA
• Tayler Hancock
• Blake G Hansen, LCSW
• Scott E Harmon, PT
• Charles F Harris, PA
• Jacqueline Hart
• Judith Anne Harvey, LPN
• Debra Ann Hathcock

• Pediatrics Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.