John M Jacobs, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

168972-1205 Issued in UT

Practice address

5444 Green St
Murray, UT 84123-5632

Phone

(801) 262-8120

Fax

(801) 262-5721

NPI assigned

Jun 7, 2006

Last updated

Sep 12, 2012By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, WA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

University of Missouri, Columbia School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Tellica Imaging - Washington LLCGroup PAC ID 0648757393, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Tellica Imaging - Washington LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1346093150
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Family Medicine

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Mountain Medical Physician Specialists PC

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1720035520

  Body Imaging

  Medicare reassignment NPD
• Tellica Imaging, LLC

  • Radiology Clinic/Center
  • Boise, ID
  • NPI 1760197198

  Diagnostic Radiology, UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  dba McKay Dee Hospitalists

  • Hospitalist Physician
  • Ogden, UT
  • NPI 1669501342
  NPD
• Ihc Health Services Inc

  dba IMED Utah Heart - Richfiled

  • Multi-Specialty Clinic/Center
  • Richfield, UT
  • NPI 1689808446
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services, Inc.

  dba Intermountain Cedar City Imaging Center MRI

  • Physiological Laboratory
  • Cedar City, UT
  • NPI 1538841747
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Ogden, UT
  • NPI 1144802802
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Orem, UT
  • NPI 1508448291
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Spanish Fork, UT
  • NPI 1518727734
  NPD

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

• Ihc Health Services Inc

  dba Intermountain Health Riverton Hospital

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health LDS Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Cedar City Hospital

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1912947995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-2647",
            "fax_number": "801-262-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "168972-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "168972-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-8403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Jackson
• Raneka Sydni Jackson
• Vittoria Rosaria Zaccardi Jackson
• Jenny Alyssa Jacobs, MS, ATC
• John Christopher Jacobs Jr., MD
• Natasha Jacobson
• A Alexander Jacoby, M.D.
• Jacquez Counseling, PLLC
• Jacob Eugene Jacquez, LCSW
• Solomon Jakomino

• Vascular & Interventional Radiology Physician in Murray, UT
• Providers in Murray, UT by specialty
• Vascular & Interventional Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.