Jessica Lauren Madert Herzog, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

8450572-1205 Issued in UT

Practice address

3397 N 1200 E Ste 103
Lehi, UT 84043-3262

Phone

(801) 797-0877

Fax

(801) 290-8141

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Upper Chesapeake Medical Services, Inc

  • Hospitalist Physician
  • Bel Air, MD
  • NPI 1497801419
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1912035221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3397 N 1200 E STE 103",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840433262",
            "telephone_number": "801-797-0877",
            "fax_number": "801-290-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3397 N 1200 E STE 103",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840433262",
            "telephone_number": "801-797-0877",
            "fax_number": "801-290-8141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Lambs Gap",
            "address_2": "Turnpaugh Health and Wellness",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "17050",
            "country_code": "US",
            "telephone_number": "717-795-9566",
            "fax_number": "717-795-9567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2507 Gettysburg Rd",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170117308",
            "country_code": "US",
            "telephone_number": "717-961-6724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "JESSICA",
        "middle_name": "LAUREN MADERT",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8450572-1205",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD449593",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD449593",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "UT",
            "license": "8450572-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "420536",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2983938",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Hemingway
• Sharee Hendricks, PMHNP-BC
• Ilene Heninger
• Kimberly Ann Henne, APRN
• Parker Anthony Hertz
• Hailey Hettich
• Tia Heule
• Breanna Hicken
• Jeffrey Alan Hicken, LMFT
• Highland Center for Integrative Medicine, LLC

• General Practice Physician in Lehi, UT
• Providers in Lehi, UT by specialty
• General Practice Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.