Individual provider Active NPI

Edward A Jordan, MD

  • Surgery Physician
  • Ogden, UT
National Provider Identifier
1740277599
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
351213-1205 Issued in UT
Practice address
4700 Harrison Blvd
Ogden, UT 84403-4303
Phone
(801) 475-3011
Fax
(801) 475-3301
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 351213-1205 UT Primary

Addresses

Primary practice location

4700 Harrison Blvd
Ogden, UT 84403-4303

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3011

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
I20080508000156 UT Practitioner - General Surgery 1850470477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic Specialty Services LLCGroup PAC ID 1658781422, 131 clinicians

Practice addresses (Care Compare)

4700 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3300

Hospital & facility affiliations

  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Surgery CurrentSince Jan 19, 1998 Accepting new patients
Ogden Clinic Specialty Services LLC Surgery CurrentSince Jan 1, 2021 Accepting new patients

Locations

4403 Harrison Blvd
Ogden, UT 84403
Phone (801) 387-2800

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

4700 Harrison Blvd
South Ogden, UT 84403
Phone (801) 475-3300

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1740277599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3011",
            "fax_number": "801-475-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3011",
            "fax_number": "801-475-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "351213-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.