Individual provider Active NPI

Jeffrey D Pierson, PA-C

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1861490609
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0285910-1206 Issued in UT
Practice address
395 W Cougar Blvd Ste 803
Provo, UT 84604-3311
Phone
(801) 235-7246
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0285910-1206 UT Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 803
Provo, UT 84604-3311

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000666 UT Practitioner - Physician Assistant 3173692324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
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

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

98 N 1100
American Fork, UT 84003-2935
Phone (801) 235-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0285910-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince May 1, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2017 Accepting new patients
Riverwoods Urgent Care Center LC PastSince Oct 6, 2003 Accepting new patients

Locations

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

412 W 800 N
Orem, UT 84057
Phone (801) 235-7246

395 W Cougar Blvd
Ste 803
Provo, UT 84604
Phone (801) 235-7246

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

819 E Market Place Dr
Fl 3
Spanish Fork, UT 84660
Phone (801) 374-1801

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15493/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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1861490609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 803",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043311",
            "telephone_number": "801-235-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "0285910-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.