Individual provider Active NPI

Jeffrey G Priest, MD

  • Anesthesiology Physician
  • Provo, UT
National Provider Identifier
1710100011
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
322221-1205 Issued in UT
Practice address
1067 N 500 W
Provo, UT 84604-3305
Phone
(801) 375-8049
Fax
(801) 374-9195
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 322221-1205 UT Primary

Addresses

Primary practice location

1067 N 500 W
Provo, UT 84604-3305

Mailing address

PO Box 1727
Provo, UT 84603-1727
Phone (801) 375-8049

Other identifiers 1

IdentifierTypeStateIssuer
562302331007MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117001081 UT Practitioner - Anesthesiology 6608776976 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322221-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Anesthesia LC Anesthesiology CurrentSince Feb 1, 2003 Accepting new patients
Mountain West Anesthesia LLC Anesthesiology PastSince Jan 1, 1998 Accepting new patients

Locations

640 W 800 N
Orem, UT 84057
Phone (801) 356-6002

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

1067 N 500 W
Provo, UT 84604
Phone (801) 356-6002

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710100011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846031727",
            "telephone_number": "801-375-8049",
            "fax_number": "801-374-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-375-8049",
            "fax_number": "801-374-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEST",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "322221-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "562302331007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.