NPIMap

Individual provider Active NPI

Jessica Woeppel, PA-C

  • Surgical Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1922874981
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
13487669-1206 Issued in UT
Practice address
4252 S Highland Dr
Salt Lake City, UT 84124-2670
Phone
(801) 965-3600
NPI assigned
Nov 30, 2023
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 13487669-1206 UT Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

4252 S Highland Dr
Salt Lake City, UT 84124-2670

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600

Other practice location 1

3895 W 7800 S Ste 100
West Jordan, UT 84088-5616
Phone (801) 280-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240228000567 UT Practitioner - Physician Assistant 3577908706 Reassigns benefits to 4 organizations
I20250527002739 TX Practitioner - Physician Assistant 3577908706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians
Utah Carenow Urgent Care LLCGroup PAC ID 7113326208, 31 clinicians

Practice addresses (Care Compare)

12391 S 4000
Riverton, UT 84096-7012
Phone (801) 302-1700

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

348 E 4500
Suite 200
Salt Lake City, UT 84107-8509
Phone (801) 262-9800

441 S Redwood Rd
Salt Lake City, UT 84104-3539
Phone (801) 973-2588

660 S 200
Salt Lake City, UT 84111-3846

660 S 200 E
Salt Lake, UT 84111-3846
Phone (801) 395-2256

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Mar 3, 2025 Accepting new patients
Granger Medical Specialists LLC CurrentSince Mar 3, 2025 Accepting new patients
Granger Medical Clinic PC CurrentSince Mar 3, 2025 Accepting new patients
Confederated Tribes of the Goshute Reservation Past Accepting new patients

Locations

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Organizations & group practices 8

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 3

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": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1922874981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 S HIGHLAND DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242670",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3895 W 7800 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840885616",
            "country_code": "US",
            "telephone_number": "801-280-7774",
            "fax_number": "801-748-2790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOEPPEL",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "13487669-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.