NPIMap

Individual provider Active NPI

James Shaffner, D.O.

  • Nephrology Physician
  • Riverton, UT
National Provider Identifier
1811375298
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
12296767-1204 Issued in UT
Practice address
12523 S Creek Meadow Rd Ste 111
Riverton, UT 84065-7291
Phone
(801) 288-2634
Fax
(801) 288-1186
NPI assigned
May 18, 2015
Last updated
May 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 12296767-1204 UT Primary

Addresses

Primary practice location

12523 S Creek Meadow Rd Ste 111
Riverton, UT 84065-7291

Mailing address

3702 S State St Ste 107
South Salt Lake, UT 84115-5096
Phone (801) 288-2634

Other practice location 1

1244 N Main St Ste 101
Tooele, UT 84074-9839
Phone (801) 288-2634

Other identifiers 1

IdentifierTypeStateIssuer
1811375298MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshaffner48055@direct.acumenmd.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913002167 UT Practitioner - Nephrology 4486943701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Utah LLCGroup PAC ID 2769468065, 31 clinicians

Practice addresses (Care Compare)

1244 N Main St
Suite 101
Tooele, UT 84074-9839
Phone (801) 288-2634

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12296767-1204UTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Kidney Clinic LLC Nephrology CurrentSince Sep 1, 2021 Accepting new patients
Nephrology Associates of Utah LLC Nephrology CurrentSince Jan 8, 2023 Accepting new patients
Liberty Dialysis-Woods Cross LLC Past Accepting new patients
Kidney & Hypertension Institute of Utah PLLC Nephrology Past Accepting new patients

Locations

1551 Renaissance Towne Dr
Ste 340
Bountiful, UT 84010
Phone (801) 288-2634

480 N 100 E
Logan, UT 84321
Phone (435) 932-2038

4345 Harrison Blvd
#101
Ogden, UT 84403
Phone (385) 350-8500

121 S Orem Blvd
Ste 103
Orem, UT 84058
Phone (801) 225-4911

1735 W 2700 N
Pleasant View, UT 84404
Phone (801) 737-9664

12523 S Creek Meadow Rd
Ste 111
Riverton, UT 84065
Phone (801) 288-2634

3702 S State St
Ste 107
South Salt Lake, UT 84115
Phone (801) 288-2634

1244 N Main St
Ste 101
Tooele, UT 84074
Phone (435) 249-0007

5285 S 400 E
#B
Washington Terrace, UT 84405
Phone (801) 476-7300

3584 W 9000 S
Ste 305
West Jordan, UT 84088
Phone (385) 350-8500

3823 W 9000 S
West Jordan, UT 84088
Phone (801) 288-2634

2965 W 3500 S
Fl 2
West Valley City, UT 84119
Phone (801) 288-2634

4101 W Pioneer Pkwy
Ste 103
West Valley City, UT 84120
Phone (801) 288-2634

572 W 750 S
Woods Cross, UT 84010
Phone (801) 288-2634

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14360/brand/20/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/19427/brand/1/csg/1/fhir/r4

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 9

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1811375298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 S CREEK MEADOW RD STE 111",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657291",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1244 N Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840749839",
            "country_code": "US",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFNER",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-18",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "12296767-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811375298",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshaffner48055@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "12523 S Creek Meadow Rd Ste 111",
            "city": "Riverton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840657291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.