NPIMap

Individual provider Active NPI

Justin W Mansfield, M.D.

  • Internal Medicine Physician
  • Ogden, UT
National Provider Identifier
1699707059
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47817351205 Issued in UT
Practice address
4403 Harrison Blvd
Ste 3875
Ogden, UT 84403-3271
Phone
(801) 387-7950
Fax
(801) 387-7955
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X V5692 TX
Internal Medicine Physician 207R00000X 20468 NV
Internal Medicine Physician 207R00000X 47817351205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd
Ste 3875
Ogden, UT 84403-3271

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Other practice location 1

1100 NE Loop 410 Ste 706
San Antonio, TX 78209-1537
Phone (210) 874-4999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050506000782 UT Practitioner - Internal Medicine 4082654124 Reassigns benefits to 3 organizations
I20200811001944 NV Practitioner - Internal Medicine 4082654124 Reassigns benefits to 1 organization
I20250331003141 TX Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 4082654124

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Utah School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians
Amazing Medical Associates IncGroup PAC ID 5991606329, 24 clinicians

Practice addresses (Care Compare)

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

434 W Ascension Way
Suite 225
Murray, UT 84123-2985
Phone (801) 716-7008

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20468NVMDInternal Medicine Physician
47817351205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier House Calls, LLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Texas Senior Care at Home LLC CurrentSince Feb 18, 2025 Accepting new patients
Diabetes Relief Utah Ogden LLC CurrentSince Nov 26, 2025 Accepting new patients
Tanner Memorial Clinic Internal Medicine Current Accepting new patients
Tanner Memorial Clinic CurrentSince Sep 1, 2015 Accepting new patients
Amazing Medical Associates, Inc CurrentSince May 9, 2019 Accepting new patients
Tanner Memorial Clinic CurrentSince Sep 1, 2015 Accepting new patients
Caylor Hospice LLC PastSince Nov 3, 2024 Accepting new patients

Locations

870 Seven Hills Dr
Ste 202
Henderson, NV 89052
Phone (702) 463-4050

6720 Via Austi Pkwy
Ste 250
Las Vegas, NV 89119
Phone (702) 463-4050

1100 NE Loop 410
Ste 706
San Antonio, TX 78209
Phone (210) 874-4999

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

434 W Ascension Way
Ste 225
Salt Lake City, UT 84123
Phone (801) 716-7008

Interoperability endpoints

  • Direct secure messaging: justin.mansfield.p1@direct.tannerclinic.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Inspiration Hospice LLCClearfield, UT, CCN 461591 Hospice Contracted Managing Employee Feb 17, 2014
Inspiration HospiceSan Antonio, TX, CCN 971587 Hospice Contracted Managing Employee (10%) May 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1699707059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "STE 3875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-7950",
            "fax_number": "801-387-7955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 NE Loop 410 Ste 706",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782091537",
            "country_code": "US",
            "telephone_number": "210-874-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "JUSTIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V5692",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "20468",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "47817351205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.