Jon W Ahlstrom MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4918766-1205 Issued in UT

Legal business name

JON W AHLSTROM MD PC

Practice address

550 E 1400 N
Ste I
North Logan, UT 84341-2406

Phone

(435) 753-1545

Fax

(435) 753-3153

NPI assigned

Mar 7, 2012

Organization subpart

No

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon W Ahlstrom, MD

  • Obstetrics & Gynecology Physician
  • Logan, UT
  • NPI 1437146065

  Obstetrics & Gynecology, UT

  Medicare reassignment NPD Authorized official
• Emily Fonua, APRN

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1184297129
  NPD
• Elizabeth Ann Booton, M.S.N, F.N.P,

  • Nurse Practitioner
  • Logan, UT
  • NPI 1447305834
  NPD (past)
• Jon Lawson Landeen, MD

  • Obstetrics & Gynecology Physician
  • Moab, UT
  • NPI 1205890928

  Obstetrics & Gynecology

  NPD (past)
• Robert P. Strebel Jr., M.D.

  • Obstetrics Physician
  • St George, UT
  • NPI 1629013248
  NPD (past)
• Marybeth Wilson, F.N.P

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1487925012
  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

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

Authorized official

Name

Jon W Ahlstrom, MDNPI 1437146065

Title

Owner

Phone

(435) 753-1545

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1679847784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E 1400 N",
            "address_2": "STE I",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "435-753-1545",
            "fax_number": "435-753-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 1400 N",
            "address_2": "STE I",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "435-753-1545",
            "fax_number": "435-753-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON W AHLSTROM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "AHLSTROM",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-753-1545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "4918766-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Marie Jackson, LCSW
• Tim Leroy Jensen, MOTR/L
• Melissa D Jex
• Karson B. Johnson, D.C.
• Suezan L Johnson, LCSW
• James Lewis Jones Jr., ACNP
• Pauline Margaret Jonsson, OTR/L
• Gina Gasser Jordan, FNP
• Nina G Jorgensen, M.D.
• Barrett Paul Labrum, D.O.

• All providers in North Logan, UT
• Obstetrics & Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.