Individual provider Active NPI

Jessica Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • West Jordan, UT
National Provider Identifier
1770094666
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
66680743102 Issued in UT
Practice address
3580 W 9000 S
West Jordan, UT 84088-8812
Phone
(801) 561-8888
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 66680743102 UT Primary

Addresses

Primary practice location

3580 W 9000 S
West Jordan, UT 84088-8812

Mailing address

2221 Lakeside Blvd Ste 600
Richardson, TX 75082-4416
Phone (469) 505-1634

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjohnson458436@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180301002479 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284995507 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Anesthesia Consultants LLCGroup PAC ID 6709837370, 5 clinicians
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

3580 W 9000
West Jordan, UT 84088-8812
Phone (801) 561-8888

5475 S 500
Ogden, UT 84405-6905
Phone (469) 998-7443

Hospital & facility affiliations

  • Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
66680743102UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Sep 8, 2025 Accepting new patients
NPH Anesthesia of Utah, LLC CurrentSince Sep 1, 2023 Accepting new patients
University of Utah Adult Services CurrentSince Aug 17, 2020 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Mountain West Anesthesia LLC CurrentSince Jan 1, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Aug 17, 2020 Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333

1820 Sidewinder Dr
Ste 200
Park City, UT 84060
Phone (435) 649-6311

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

8th Ave C St E
Salt Lake City, UT 84143
Phone (218) 929-0674

5450 S Green St
#B
Salt Lake City, UT 84123
Phone (801) 290-6060

6322 S 3000 E
Ste 170
Salt Lake Cty, UT 84121
Phone (801) 513-3223

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

765 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-5000

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 7

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1770094666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LAKESIDE BLVD STE 600",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824416",
            "telephone_number": "469-505-1634",
            "fax_number": "469-436-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888812",
            "telephone_number": "801-561-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "66680743102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson458436@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.