Individual provider Active NPI

Jennifer Jett, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Provo, UT
National Provider Identifier
1770046617
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
13248644-1205 Issued in UT
Practice address
395 W Cougar Blvd Ste 102
Provo, UT 84604-3334
Phone
(801) 357-8586
Fax
(801) 357-7786
NPI assigned
Apr 8, 2019
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 13248644-1205 UT
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 13248644-1205 UT Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 102
Provo, UT 84604-3334

Mailing address

395 W Cougar Blvd Ste 102
Provo, UT 84604-3334
Phone (801) 357-8586

Other practice location 1

9500 Euclid Ave # Na-23
Cleveland, OH 44195-1013
Phone (800) 223-2273

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
I20230912003262 UT Practitioner - Hospice/Palliative Care 0648507822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Provo, UT 84604-3311
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13248644-1205UTMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 27, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 27, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Provo, UT 84604
Phone (801) 357-4141

395 W Cougar Blvd
Ste 102
Provo, UT 84604
Phone (801) 357-8586

5171 S Cottonwood St
Ste 610
Salt Lake City, UT 84107
Phone (801) 507-3630

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1770046617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 102",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043334",
            "telephone_number": "801-357-8586",
            "fax_number": "801-357-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 102",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043334",
            "telephone_number": "801-357-8586",
            "fax_number": "801-357-7786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave # Na-23",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441951013",
            "country_code": "US",
            "telephone_number": "800-223-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JETT",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "13248644-1205",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "13248644-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.