Jacob C Worley, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

14209819-1204 Issued in UT

Practice address

560 W 465 N Ste 604
Providence, UT 84332-8006

Phone

(435) 994-2535

NPI assigned

Mar 30, 2021

Last updated

Jun 17, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interwest Anesthesia Associates LLCGroup PAC ID 0042293359, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
• Cache Valley Hospital Hospital, North Logan, UT, CCN 460054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Interwest Anesthesia Associates LLC

  • Anesthesiology Physician
  • Providence, UT
  • NPI 1841214483
  Medicare reassignment Care Compare group NPD

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

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation
• Mountain Division - CVH, LLC

  dba Cache Valley Hospital

  • General Acute Care Hospital
  • North Logan, UT
  • NPI 1952703472
  Care Compare affiliation

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1821676099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-994-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORLEY",
        "first_name": "JACOB",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "14209819-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821676099",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Thomas Willmore, DPM
• Justin Ray Winchell, RBT
• Allie Winter, RBT
• Aubrey Lynn Wood, RBT
• Rachel K Wood, RBT
• Nathan Jay Zurcher

• Anesthesiology Physician in Providence, UT
• Providers in Providence, UT by specialty
• Anesthesiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.