Jennifer Leigh Mooney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

76774571206 Issued in UT

Practice address

1064 E Bamberger Dr
American Fork, UT 84003-5504

Phone

(801) 332-9151

NPI assigned

Sep 17, 2014

Last updated

Apr 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Leigh Bloomfield Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805
  Medicare reassignment NPD
• Jordan Ridge Family Medicine LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1770509754
  Medicare reassignment NPD (past)
• After Hours Medical LLC

  dba Medallus Medical

  • Urgent Care Clinic/Center
  • Draper, UT
  • NPI 1437251279
  Medicare reassignment
• Jordan Ridge Family Medicine LLC

  • Family Medicine Physician
  • West Valley City, UT
  • NPI 1306275227
  Medicare reassignment
• After Hours Medical LLC, Dba Medallus Medical

  dba After Hours Medical - Sandy Clinic

  • Urgent Care Clinic/Center
  • Sandy, UT
  • NPI 1366559791
  NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD
• Preservemd LLC

  dba Sundwall Family Medicine

  • Family Medicine Physician
  • Highland, UT
  • NPI 1942881867
  NPD (past)

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1841692233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 E BAMBERGER DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840035504",
            "telephone_number": "801-332-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 E BAMBERGER DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840035504",
            "telephone_number": "801-332-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7677457-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "76774571206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BLOOMFIELD",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louis Andrew Monson, PT, DPT
• Steven Monson, M.D.
• Jason T Montgomery, PA
• Emily Moody
• Sandy G Moody, LCSW
• Madison Taylor Moore, RD
• Mikayla Morgan
• Natassja Morgan
• Marla Morillo
• Kimberly Mortenson, NP

• Physician Assistant in American Fork, UT
• Providers in American Fork, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.