NPIMap

Individual provider Active NPI

Jacob C Juarez, PA-C, MPAS

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1740756816
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11022394-1206 Issued in UT
Practice address
2084 N. 1700 W.
Suite a
Layton, UT 84041
Phone
(801) 773-8644
NPI assigned
Oct 16, 2018
Last updated
Oct 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11022394-1206 UT Primary

Addresses

Primary practice location

2084 N. 1700 W.
Suite a
Layton, UT 84041

Mailing address

2084 N. 1700 W.
Suite a
Layton, UT 84041
Phone (801) 773-8644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11022394-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Families First Pediatrics LLC Past Accepting new patients
Families First Pediatrics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1740756816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 N. 1700 W.",
            "address_2": "SUITE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-773-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 N. 1700 W.",
            "address_2": "SUITE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-773-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "JACOB",
        "middle_name": "C",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11022394-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.