Individual provider Active NPI

Samantha Lyn Clarkson, FNP-C

  • Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1891280343
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8506342-4405 Issued in UT
Practice address
4403 Harrison Blvd Ste 3875
Ogden, UT 84403-3332
Phone
(801) 387-7950
NPI assigned
Jun 27, 2018
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8506342-4405 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 3875
Ogden, UT 84403-3332

Mailing address

4403 Harrison Blvd Ste 3875
Ogden, UT 84403-3332
Phone (801) 387-7950

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidUT

Other names 1

  • Samantha Lyn Hager Former name

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
I20180725003596 UT Practitioner - Nurse Practitioner 4284981903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

4403 Harrison Blvd
Suite 3875
Ogden, UT 84403-3332
Phone (801) 387-7950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 7, 2022 Accepting new patients
Ogden Clinic Specialty Services LLC Current Accepting new patients
Ogden Clinic PC Nurse Practitioner CurrentSince Jul 1, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 7, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

4403 Harrison Blvd
Ste 3875
Ogden, UT 84403
Phone (801) 387-7880

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

5740 Crestwood Dr
South Ogden, UT 84405
Phone (801) 479-7771

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 6

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 2

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1891280343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033332",
            "telephone_number": "801-387-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033332",
            "telephone_number": "801-387-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "SAMANTHA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8506342-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HAGER",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.