NPIMap

Individual provider Active NPI

Jonathan Andrew Hartshorn, M.D.

  • Epilepsy Physician
  • Provo, UT
National Provider Identifier
1932553773
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
12127629-1205 Issued in UT
Practice address
395 W Cougar Blvd Ste 801
Provo, UT 84604-3311
Phone
(801) 229-1054
NPI assigned
Apr 18, 2016
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 12127629-1205 UT
Epilepsy Physician 2084E0001X 12127629-1205 UT Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 801
Provo, UT 84604-3311

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

5171 S Cottonwood St Ste 810
Murray, UT 84107-5705
Phone (801) 507-9800

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827000630 UT Practitioner - EpileptologistsPractitioner - Neurology 0941593636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EpileptologistsAlso: Neurology
Education
Oakland Univ, William Beaumont School of Medicine, 2016
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
Suite 502
Provo, UT 84604-3323
Phone (801) 357-8818

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12127629-1205UTMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 15, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 15, 2021 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

395 W Cougar Blvd
Provo, UT 84604
Phone (801) 357-4141

395 W Cougar Blvd
Ste 502
Provo, UT 84604
Phone (801) 229-1054

395 W Cougar Blvd
Ste 801
Provo, UT 84604
Phone (801) 229-1054

5171 S Cottonwood St
Ste 810
Salt Lake City, UT 84107
Phone (801) 507-9800

5770 S 250 E
Ste 135
Salt Lake Cty, UT 84107
Phone (801) 263-3416

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1932553773",
    "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 801",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043311",
            "telephone_number": "801-229-1054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5171 S Cottonwood St Ste 810",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075705",
            "country_code": "US",
            "telephone_number": "801-507-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTSHORN",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "12127629-1205",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "UT",
            "license": "12127629-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.